Register for the Take A Breather 5k, Longport, NJ

Registration Fee: $25

Primary Registration Information
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Additional Registrants
additional registrant(s) at $25 (each).
Additional Registrant One
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Additional Registrant Two
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Additional Registrant Three
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Additional Registrant Four
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Support a Child's Wish

I would like to make an additional donation to support a wish for a child battling cystic fibrosis.

Additional Information
Payment Information
CVV2 Info
Waiver

I hereby waive all claims against the Take A Breather Foundation, sponsors, or personnel for any injury that I may suffer from my participation in this event. I grant full permission for organizers to use photographs, videos, recordings or any other record of this event in which I may appear for any legitimate reason. Having read this waiver and knowing these facts, and in consideration of this acceptance of my entry, I hereby for myself, my heirs, executors, administrators or anyone else who might claim on my behalf, covenant not to sue, and waiver, release and discharge TakeA Breather Foundation, The Borough of Longport, NJ, event officials, volunteers, and any other sponsors, suppliers, agents, independent contractors, employees and other personnel in any way assisting or connected with this event. I am over 17 years old, or if applicable, I am the parent or legal guardian if the child under 18 years old whom I am registering for this event, and I have the full power and authority to agree to these terms on behalf of such child, and bind him/her to the terms. I have read this waiver.

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