Register For
Belmar Five Mile Run

Belmar, NJ 07719

Registrant #1

Who are you registering? *


By selecting this box, you are indicating that you are the parent/guardian of the person you are about to register. Additionally, if the child is under the age of 13, you are consenting to the collection and use of the information about the child for the purpose of the registration as described in our privacy policy.

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Basic Info

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Additional Information

Format: mm/dd/yyyy
Used for age group calculations
Format: ###-###-####

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Choose Your Event *

Saturday September 4, 2021

$30.00 + $3.00 SignUp Fee

Saturday September 4, 2021

$30.00 + $3.00 SignUp Fee

Friday September 3, 2021

$10.00 + $2.00 SignUp Fee

Waiver

In consideration of you accepting this entry, I, the participant, intending to be legally bound and hereby waive or release the Goodwill Hose Company, Jersey Shore Running Club, the Borough of Belmar, the Belmar Five, the Event Director, RunSignUp.com, and all of their officers and agents assisting with the event, , all sponsors, their representatives and successors, including the Road Runners Club of America, its officers, directors, agents and employees from all claims or liabilities of any kind arising from my participation in this event even though liability may arise out of negligence or carelessness on the part of the persons named in this waiver. This release includes all injuries and/or damages suffered by me or my personal property before, during or after the event. I recognize, intend and understand that this release is binding on my heirs, executors, administrators, or assignees.

I know that running a road race is a potentially hazardous activity. I should not enter and run unless I am medically able to do so and properly trained. I assume all risks associated with running in this event including, but not limited to: falls, contact with other participants, the effects of weather, traffic, and course conditions, and waive any and all claims which I might have based on any of those and other risks typical found in running a road race. I acknowledge all such risks are known and understood by me. I agree to abide by all decisions of any race official relative to my ability to safely complete the run. I certify as a material condition to my being permitted to enter this race that I am physically fit and sufficiently trained for the completion of this event and that a licensed Medical Doctor has verified my physical condition.

I further agree to abide by current New Jersey State Executive Orders and any local ordinances related to public health issues and the Center for Disease Control’s (CDC) recommendations for the prevention of the spread of the 2019 Novel Coronavirus Disease (COVID-19) and other communicable diseases, and I attest to having read the CDC’s guidance at: https://www.cdc.gov/coronavirus/2019-ncov/prepare/prevention.html.  I assume all such risks being known, appreciated, and accepted by me.  In addition, I acknowledge the contagious nature of COVID-19 and other communicable diseases and voluntarily assume the risk that I may be exposed to or infected by COVID-19 and/or other communicable diseases by participating in any activities associate with JSRC.  I acknowledge that such exposure or infection may result in personal injury, illness, permanent disability, and/or death.  I understand that the risk of becoming exposed to or infected by COVID-19 in connection with my participation in any club activities, and personally assume this risk.

In the event of an illness, injury or medical emergency arising during the event I hereby authorize and give my consent to the Event Director to secure from any accredited hospital, clinic and/ or physician any treatment deemed necessary for my immediate care. I agree that I will be fully responsible for payment of any and all medical services and treatment rendered to me including but not limited to medical transport, medications, treatment and hospitalization.

By submitting this entry, I acknowledge (or a parent or adult guardian for all children under 18 years) having read and agreed to the above release and waiver.

Further, I grant permission to all the foregoing to use my name, voice and images of myself in any photographs, motion pictures, results, publications or any other print, videographic or electronic recording of this event for legitimate purposes. I understand that the events will be held rain or shine- and no refunds will be issued.

 




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