Pastor’s 1 Mile Run Walk

2014   WELLNESS ROCKS @ ALL AGES

PASTOR’S  1 MILE RUN/WALK

I am over the age of 19 and have guardian consent

I understand that my participation in this 1 MILE FUN RUN/WALK is voluntary

I assume full responsibility for any injury and/or accident which may occur during this event and/or while I am on the premise of this event

I hereby release in whole harmless Sixth Avenue Baptist Church and all associated with this event from any and all injuries or damage whether it is caused by negligence

I understand that pictures and images may be taken to appear on website and social mediathis is a health screening and that I may be asked to consult with my physician

☐ I agree to take part in the 1 mile Fun Run/Walk

Name

Guardian

Phone

Email