The St. Mary's County Community Mediation Center 301-475-9118, 12 Courthouse Drive, Rear Entrance, P.O. Box 853, Leonardtown, MD 20650

Making Peace Together



1st Annual
“We're Looking for Trouble” 5K
and 1 Mile Kids’ Fun Run

Registration Information

Welcome! Enter your information below to register for the Fun Run.

After completing the form, you will be offered a button to pay the $25 pre-registration fee by PayPal.
Payment can also be sent by Check (payable to CMCSM) to:

Community Mediation Centers of Southern Maryland
P.O. Box 853
Leonardtown, MD 20650

Name:
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Street Address:
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Sex: Male
Female
T-Shirt Size: S
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I will be partipating as part of a team: No
Yes
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Would you like more information about the Mediation Center? If so, please check the appropriate boxes: Mediation Services
Community Program
Court Program
Volunteer Opportunities
Training Information
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Comments:

LIABILITY AND PUBLICATION RELEASE/APPLICATION
I have full knowledge of and assume the risks (heat exhaustion, heat stroke, personal injury, etc.) involved in training for and participating in the “We’re Looking for Trouble” 5K Run and 1 Mile Kids Fun Run and represent that I am physically fit and have sufficiently trained to participate therein. Because you are relying on these representations and in consideration of your accepting my entry into the Event, I, for myself, my executors, administrators and assignees, do hereby release and discharge the Community Mediation Centers of Southern Maryland, CMCSMC and any and all sponsors of the Event, and the respective officers, directors, agents and employees of the foregoing, jointly and separately, from and against all actions, claims, demands or damages which in any way arise out of or result from my training for or participating in the Event or Event-related events. I further agree you may subsequently use for publicity and/or promotional purposes, without any obligation or liability to me, my name and any picture of my participation in the Event. Please be assured that I have carefully read and do understand the foregoing waiver and that I am signing it of my own free will.

I accept the above Liability and Publication Release/Application.