Attention... registration for this event closed on Wednesday August 22nd, 2012 - Start of Day (USCT). Race Information Race Name: RUN AND WINE 5K/10K RUN/WALK Location: Fremont State: Indiana, United States Posted: March 22nd, 2012 2:15 pm Last Update: June 4th, 2012 2:23 pm   Event Information Name of Event: RUN AND WINE 5-Km Distance: 5.00 Measurement: Kilometers Date: Saturday August 25th, 2012 Start Time: 8:00 am Special Instructions: Each participant receives a commemorative First Annual RUN & WINE t-shirt! Event Registration Schedule Opened: Friday April 20th, 2012 Start of Day Deadline passed: Wednesday August 22nd, 2012 12:00 am  $ 20.00 Unless otherwise noted ... Registration Dates & Times are based upon US Central Time.    Step 1 of 2 - Participant Registration First Name   Last Name Address 1 Address 2 City State / Province Use 2 digit code for US and Canada otherwise, leave blank.    Country, if outside of the U.S. and Canada Leave blank if address is in US or  Canada. Zip / Postal Code Email Address Participant's Email Address... check for accuracy, and be sure to allow incoming messages from: RunRace.net Participant's Date of Birth Format: YYYY-MM-DD Sex M for Male, F for Female. Shirt Selection < Select Shirt >SmallMediumLargeX-Large2X-Large Waiver Shape Up Steuben Event Liability Waiver and Release (must be signed) The individual identified below submits and signs this waiver and release as a (1)participant in an event sponsored by Shape Up Steuben, and /or (2) parent, legal guardian or attorney-in-fact of a participant in an event by Shape Up Steuben. This Waiver and Release applies to and is binding upon the individual submitting the Waiver and Release in each capacity listed above. The Participant understand the nature of the Event and the risks involved in participating in the Event (including the training portion for the event organized by Shape Up Steuben Training series). The Participant knows that running and/or walking a road race can potentially be a hazardous activity. Participant understand that an individual should not participate unless medically able and sufficiently trained to do so. The Participant understand that while Police and Fire protection will be provided during portions of the Event held on August 25, 2012, there may still be automobile and other traffic on or near the course. Participant assumes all risks associated with their voluntary participation in the Event including, but not limited to, automobile and other traffic and other conditions of the road, falls, contact with other participants or volunteers, and the effects of the weather, including extreme temperatures and precipitation. The participant gives permission to Shape Up Steuben and its officers, race officials, police, fire, emergency, and medical personnel supporting the Event to obtain and provide Participant medial assistance in the event of an emergency. This permission will include the administration of medicines, surgical treatment, X-ray examination or hospitalization as might be ordered by a licensed medial doctor or certified medial professional. Participant releases and discharges Shape Up Steuben, its officers, race officials, police, fire, emergency, and medical personnel supporting the event from any liability for any first aid rendered or treatment performed pursuant to this consent. Participant irrevocably consents and authorizes Shape Up Steuben or anyone authorized by Shape Up Steuben, to take, use, reproduce, transmit, display and publish information, photographs, images, or recordings containing Participant’s name and biographical information, results, voice, image, likeness and distinctive appearance, gestures, signature and/or mannerisms in marketing material in any form or medium known or hereafter to be known, discovered, or developed. Knowing these facts, for and in consideration of participation in the Event, Participant for myself, my heirs, executors, administrators, or anyone else who might claim on my behalf, covenants not to sue and fully releases and discharges Shape Up Steuben, the Town of Fremont, Steuben County, Satek Winery, runrace.net, event sponsors, event participants, event officials, event suppliers, workers, volunteers and any and all officers, directors, employees, and other representatives of the Event and holds and waives them harmless from and against ANY AND ALL actions, claims, injuries, demands, liabilities, loss, damage, or expense, including but not limited to death, personal injury, and property damage, weather foreseen or unforeseen, arising out of, or in the course of Participant’s participation in the Event. Any participant in an Event is expressly conditioned upon Participant’s agreement to this waiver and Release and by signing or electronically submitting this entry form Participant understands and agrees with all terms of this Waiver and Release. Participant has read, understood, and accepts the agreement above. You must be 18 years of age to legally complete this registration. If the registrant is under 18, an authorized adult must complete the form.  Agree to waiver by checking here. By agreeing to this waiver you submit to the terms and conditions as set forth by this event and certify that you have provided true and accurate information as requested through this registration process. The registration deadline for this Event has passed... registration is no longer open. 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