2021 Run Now, Wine Later

First Name*

Last Name*

Email Address*

Cell Phone*

Home Address*

Street Address:

Postal Code:

e.g. "90210" or "V0E 2S0"

City:

State/Province:

Postal Code:

Country:

Gender*

Birthday*

Age on raceday*

Race day is 10/02/2021

Shirt Size*

Name on Bib Info

Please enter the text you would like printed on your bib

Emergency Contact Name*

Please enter the name of the person we could reach on your behalf in case of emergency

Emergency Contact # *

Phone number of the Emergency Contact listed above

Legal Waiver*

By clicking and agreeing in my capacity as an adult 18 years of age or older I hereby provide consent for myself to participate in The 2021 Run Now Wine Later event. I understand participation in this event is potentially dangerous and that injuries are possible and I agree to Hold Harmless and Indemnify RunCanton Inc. The City of Canton Gervasi Vinyards Race OrganizersVolunteers and all sponsors and supporters from any and all liability including but not limited to liability for any injuries or damages sustained by myself my teammates or my child as a result of participation in the event held on October 2 2021. In addition I understand that there are many fixed costs associated with event production and as such there are NO REFUNDS in the event that I am unable to attend.

I have read and agree to the terms above.

Group Member #2, First Name*

Group Member #2, Last Name *

Group Member #2 Email Address *

Group Member #2, Gender *

Group Member #2, Birthday*

Group Member #2, Age on raceday *

Race day is 10/02/2021

Group Member #2, Shirt Size *

Group Member #2, Name on Bib Info

Please enter the text you would like printed on their bib

Group Member #2, Emergency Contact Name*

Please enter the name of the person we could reach on your behalf in case of emergency

Group Member #2, Emergency Contact # *

Phone number of the Emergency Contact listed above

Group Member #2, Legal Waiver *

By clicking and agreeing in my capacity as an adult 18 years of age or older I hereby provide consent for myself to participate in The 2021 Run Now Wine Later event. I understand participation in this event is potentially dangerous and that injuries are possible and I agree to Hold Harmless and Indemnify RunCanton Inc. The City of Canton Gervasi Vinyards Race OrganizersVolunteers and all sponsors and supporters from any and all liability including but not limited to liability for any injuries or damages sustained by myself my teammates or my child as a result of participation in the event held on October 2 2021. In addition I understand that there are many fixed costs associated with event production and as such there are NO REFUNDS in the event that I am unable to attend.

I have read and agree to the terms above.

Group Member #3, First Name *

Group Member #3, Last Name*

Group Member #3 Email Address *

Group Member #3, Gender *

Group Member #3, Birthday *

Group Member #3, Age on raceday *

Race day is 10/02/2021

Group Member #3, Shirt Size *

Group Member #3, Name on Bib Info

Please enter the text you would like printed on their bib

Group Member #3, Emergency Contact Name*

Please enter the name of the person we could reach on your behalf in case of emergency

Group Member #3, Emergency Contact # *

Phone number of the Emergency Contact listed above

Group Member #3, Legal Waiver *

By clicking and agreeing in my capacity as an adult 18 years of age or older I hereby provide consent for myself to participate in The 2021 Run Now Wine Later event. I understand participation in this event is potentially dangerous and that injuries are possible and I agree to Hold Harmless and Indemnify RunCanton Inc. The City of Canton Gervasi Vinyards Race OrganizersVolunteers and all sponsors and supporters from any and all liability including but not limited to liability for any injuries or damages sustained by myself my teammates or my child as a result of participation in the event held on October 2 2021. In addition I understand that there are many fixed costs associated with event production and as such there are NO REFUNDS in the event that I am unable to attend.

I have read and agree to the terms above.

Group Member #4, First Name *

Group Member #4, Last Name*

Group Member #4 Email Address *

Group Member #4, Gender *

Group Member #4, Birthday *

Group Member #4, Age on raceday *

Race day is 10/02/2021

Group Member #4, Shirt Size *

Group Member #4, Name on Bib Info

Please enter the text you would like printed on their bib

Group Member #4, Emergency Contact Name*

Please enter the name of the person we could reach on your behalf in case of emergency

Group Member #4, Emergency Contact #*

Phone number of the Emergency Contact listed above

Group Member #4, Legal Waiver *

By clicking and agreeing in my capacity as an adult 18 years of age or older I hereby provide consent for myself to participate in The 2021 Run Now Wine Later event. I understand participation in this event is potentially dangerous and that injuries are possible and I agree to Hold Harmless and Indemnify RunCanton Inc. The City of Canton Gervasi Vinyards Race OrganizersVolunteers and all sponsors and supporters from any and all liability including but not limited to liability for any injuries or damages sustained by myself my teammates or my child as a result of participation in the event held on October 2 2021. In addition I understand that there are many fixed costs associated with event production and as such there are NO REFUNDS in the event that I am unable to attend.

I have read and agree to the terms above.

Group Member #5, First Name *

Group Member #5, Last Name *

Group Member #5 Email Address *

Group Member #5, Gender *

Group Member #5, Birthday*

Group Member #5, Age on raceday *

Race day is 10/02/2021

Group Member #5, Shirt Size *

Group Member #5, Name on Bib Info

Please enter the text you would like printed on their bib

Group Member #5, Emergency Contact Name*

Please enter the name of the person we could reach on your behalf in case of emergency

Group Member #5, Emergency Contact # *

Phone number of the Emergency Contact listed above

Group Member #5, Legal Waiver*

By clicking and agreeing in my capacity as an adult 18 years of age or older I hereby provide consent for myself to participate in The 2021 Run Now Wine Later event. I understand participation in this event is potentially dangerous and that injuries are possible and I agree to Hold Harmless and Indemnify RunCanton Inc. The City of Canton Gervasi Vinyards Race OrganizersVolunteers and all sponsors and supporters from any and all liability including but not limited to liability for any injuries or damages sustained by myself my teammates or my child as a result of participation in the event held on October 2 2021. In addition I understand that there are many fixed costs associated with event production and as such there are NO REFUNDS in the event that I am unable to attend.

I have read and agree to the terms above.

Group Member #6, First Name *

Group Member #6, Last Name *

Group Member #6 Email Address *

Group Member #6, Gender *

Group Member #6, Birthday *

Group Member #6, Age on raceday *

Race day is 10/02/2021

Group Member #6, Shirt Size *

Group Member #6, Name on Bib Info

Please enter the text you would like printed on their bib

Group Member #6, Emergency Contact Name*

Please enter the name of the person we could reach on your behalf in case of emergency

Group Member #6, Emergency Contact # *

Phone number of the Emergency Contact listed above

Group Member #6, Legal Waiver *

By clicking and agreeing in my capacity as an adult 18 years of age or older I hereby provide consent for myself to participate in The 2021 Run Now Wine Later event. I understand participation in this event is potentially dangerous and that injuries are possible and I agree to Hold Harmless and Indemnify RunCanton Inc. The City of Canton Gervasi Vinyards Race OrganizersVolunteers and all sponsors and supporters from any and all liability including but not limited to liability for any injuries or damages sustained by myself my teammates or my child as a result of participation in the event held on October 2 2021. In addition I understand that there are many fixed costs associated with event production and as such there are NO REFUNDS in the event that I am unable to attend.

I have read and agree to the terms above.

2021 Run Now, Wine Later

Run Now, Wine Later - July Group of 6 Registration - Registration Form