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Walk for Chornobyl 5K Registration Form
and Liability Waiver

To register online please fill out the form below and sign the liability waiver. Click the ACCEPT button and submit your $25 registration fee. PLEASE REVIEW all of your information carefully before submitting.

If you wish to mail your registration form, liability form and registration fee please click here for a printable version of these forms and mail it to the address below. Please make checks payable to Tremont Walk for Chornobyl.

Tremont Walk for Chornobyl
P.O. Box 347095
Parma, Ohio 44134

Registration Form
Rev Dr Mr Mrs Ms
First name
Last name
Organization
Address
City
State
Zip code
Phone
Email
Number of registrants
Registrants' names (age 18 & above)
All participants will receive a Tremont Walk for Chornobyl t-shirt. Please indicate your t-shirt size below:
Small Medium Large X-Large

Liability Waiver
Every participant will be required to sign a liability waiver before the event. The waiver releases Tremont Walk for Chornobyl from liability for injury or accident caused by or related to participation in the walk. Please read and sign below. I hereby waive all claims against Tremont Walk for Chornobyl, sponsors or any personnel for injury I might suffer in this event. I attest that I am healthy and physically able to participate and that I am 18 years of age or older. I grant full permission for Tremont Walk for Chornobyl to use photographs and quotations from me in legitimate accounts and promotions of this event.
Name
		(Participants under the age of 18 must enter their name below with the name of their parent/guardian above)
Child's Name and date of birth		Name-mm/dd/yyyy

Click here for printable version