Pacing 4 Pieces 2018 Registration

5K Run/Walk & Half Marathon
Benefitting All 4 Autism
Downtown Florence

Race Date: Saturday, March 10, 2018

For Event Details:

Runner Information

Gender *
Choose Race *
Emergency Contact
Terms & Conditions Agreement

Waiver of Liability: In consideration of my entry being accepted, I waive any and all claims for myself, my administrators, and my heirs against all officials, sponsors, and organizations (including Innovative Timing Systems, All 4 Autism, Florence City and County Police Departments) connected with the Pacing 4 Pieces Half Marathon & 5k Run/Walk and Piece Jam for injury or illness that may directly or indirectly result from my participation in this event. I attest that I have full knowledge of the risks involved in this event, and I am physically fit and sufficiently trained to participate in this event. 

Photo Release: All 4 Autism and its authorized representatives have my permission to record on photography film and/or video, pictures of myself. I further agree that any or all of the material photographed may be used, in any form, as part of any future publications, brochure, or other printed materials used to promote All 4 Autism, and further that such use shall be without payment of fees, royalties, special credit or other compensation.

Signature *
Signature of Legal Guardian (if Participant is under 18 years of age and/or Developmentally Disabled)