Rotary 5K Run/Walk to Eradicate Polio - 14th Annual

Saturday, August 17, 2024 at Shoaff Park in Fort Wayne, IN

What category would you like to sign up for? You can sign up for any of the following categories.

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Event Waiver

I, the undersigned, realize that running/walking a road race is a potentially hazardous activity. I should not enter and run/walk unless I am medically able and properly trained. I agree to abide by any decisions of a race official relative to safely completing the run. I assume all risks associated in running/walking this event including, but not limited to, falls, contact with other participants, the effects of the weather, traffic, and the conditions of the road, all such risks being known and approved by me. Having read this waiver, and knowing these facts, and in consideration of you accepting my entry, I for myself and anyone entitled to act in my behalf, waive and release Anthony Wayne Rotary, Fort Wayne Rotary, Summit South Rotary various branches and subdivisions thereof, Parks and Recreation Department, Fort Wayne Running Club, all sponsors, their representatives and successors from all claims of liability of any kind arising out of my participation in this event. I hereby grant full permission to any or all of the foregoing to use any photographs, video tapes, motion pictures, recordings, and/or other record of this event for any legitimate purpose. All race entries are non-refundable. We reserve the right to reject entries.

Please Sign Below

Your electronic signature is the online equivalent of your ink-on-paper signature, and can be provided by typing your name where indicated. The electronic signature will signify your understanding, acceptance, and authorization to accept the conditions of this legal document, including the following statements:

  • I have read, have understood, and do accept the agreement above.
  • I understand that this is a legal document with effects that I approve and authorize.
  • The registrant is the person(s) whose name is submitted as the recipient of the goods and services provided as a result of this transaction.
  • I am authorized to agree to the terms of this document on behalf of the registrant.
  • If the registrant is under 18 years of age, incapacitated, or mentally challenged, I assert that I am the parent/legal guardian or otherwise authorized to execute a legally binding agreement on behalf of the registrant.

Electronic Signature

You must be 18 years of age to legally complete this registration. If the registrant is under 18, an authorized adult must complete this form.
If the person you are registering (registrant) is under 18, do not enter his/her age. You will do that on the next step. Enter your age here as the person completing the form.




Multiple signers should separate their signatures with commas.


This agreement was generated at 3:53:32 PM EDT on 05/02/2024.