Walk Trot 5K

Name(Required)

First Last

Are There Minors In Your Party? If yes, what are their names? If no, enter N/A(Required)

Phone(Required)

Email(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Emergency Contact Name(Required)

First Last

Emergency Contact Phone(Required)

Enter the t-shirt sizes for each attendee.

Youth Sizes	Adult Sizes
YS	S
YM	M
YL	L
YXL	XL
	2XL

Enter T-shirt Sizes Below(Required)

Consent(Required)

LIABILITY WAIVER Florence Area Humane Society and Naturally Outdoors Property Visitor Waiver of Liability and Assumption of Risk You are waiving legal rights - please read carefully! This waiver is executed on the date submitted by the undersigned for themselves and/or as the lawful parent or guardian of a minor (collectively the "Visitor") Check the box to acknowledge each statement 1.* The Visitor has been granted access to the facilities of the Florence Area Humane Society, Jayne Boswell Animal Shelter located at 1434 McCurdy Road, Florence, South Carolina 29506 or a remote Humane Society event site which includes Naturally Outdoors Property, McLeod Fitness Center property and City of Florence Property and is subject to the following requirements: - Under no circumstances are minor children to be left unattended or unsupervised -All Visitors are responsible for keeping their dog under control at all times. Dogs must be people and dog friendly and age 6 months or older -Visitors are responsible for picking up after their own dog and must bring their own waste clean-up -Dogs must be up to date on all vaccinations -All Visitors must clean up after their pet -All Visitors must keep their dog on a leash. Retractable leashes are discouraged but if used must be locked at 4 ft at all times -Strollers are permitted but dogs must still be on a leash. 2.* The Visitor assumes full responsibility for any risk, injuries, and/or damages that the Visitor (and any owned companion animals or property) may incur while on the premises or while attending a Humane Society off-site event. The Visitor voluntarily accepts and assumes the risks of being on the premises or attending an offsite Humane Society event knowing that animals are capable of causing serious injury. 3.* The Visitor releases, discharges and promises not to sue the Florence Area Humane Society, its volunteers, agents, corporate sponsors/partners, guest or Naturally Outdoors Property, McCleod Fitness Center or City of Florence for any and all risks, injuries, and damages resulting from or related to the Visitor (and any owned companion animals or property)'s presence on the Premises of or at a Humane Society offsite event. Visitor understands and agrees to all of the terms in this Waiver of Liability and Assumption of Risk.

Walk Trot 5K Ticket(Required)

Individual - $20

Family (up to 4 people) - $30

Payment Method(Required)