Child Registration

Parent's Full Name (required):

Telephone Number:

Your Email (required):

Child's Full Name (required):

Address, City, State, ZIP

Child's Date of Birth (MM/DD/YYYY):

Gender: FemaleMale

Child's Height:

Child's Weight:

Type of Disability:

Do you have your own wheelchair or racing stroller?
YesNoN/A

Special Needs:

T-Shirt Size (Adult Sizing):
SmallMediumLargeX-Large

How did you hear about Push To The Finish?

Add me to your mailing list for future races

Please read and agree below by checking the box and signing with your full name:

In exchange for participating as a Runner or Non-Runner for PUSH TO THE FINISH and/or use of
the property, facilities and services of PUSH TO THE FINISH I agree for myself and (if applicable)
for the members of my family, to the following:

1. I agree to observe and obey all posted rules and warnings, and further agree to follow any
oral instructions or directions given by PUSH TO THE FINISH or the employees,
representatives, or agents such PUSH TO THE FINISH.

2. I recognize that there are certain inherent risks associated with the above described activity
and I assume full responsibility for personal injury to myself and (if applicable) my family
members, and further release and discharge PUSH TO THE FINISH for injury, loss, or damage
arising out of my participation in the above described event, whether caused by the fault of
myself or any other third party.

3. I agree to indemnify and defend PUSH TO THE FINISH against all claims, causes of action,
damages, judgments, costs or expenses including attorneys fees and other litigation costs,
which may in any way arise from my participation as a Runner in PUSH TO THE FINISH’s
program.

4. Any legal or equitable claims that may arise from participation in the above entitled event
shall be resolved under Utah law.

I HAVE READ THIS DOCUMENT AND UNDERSTAND IT. I FURTHER UNDERSTAND THAT BY ENTERING MY FULL NAME BELOW THIS RELEASE, I VOLUNTARILY SURRENDER CERTAIN LEGAL RIGHTS.

Enter full name:

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