Name(required) Email(required) Emergency contact Name(required) Emergency contact Number (required) Any medical conditions (required) When was the last time you exercised?(required) Waiver & Release: I acknowledge that my participation in the couch 2 5K and involves a risk of injury, including bodily injury, and assume the risk for same. On my own behalf and on behalf of my heirs and legal representatives and to the fullest extent permitted by law, I hereby release and discharge Team Deane Community Triathlon Club and their respective officers, affiliates, members and representatives, of and from any and all liability for injury, death, or damages and/or any other claims, demands, losses or damages, incurred by me in connection with any aspect of the and walk and participation in couch 2 5K. Please e-sign in agreement to these terms(required) Signature (required) Submit Δ AdvertisementShare this:TwitterFacebookLike this:Like Loading...