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{{ 'LAST-NAME' | translate}}

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{{ 'IDENT.SERIES_RACE_AGE_ERROR' | translate }}

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{{ 'PARTICIPANT-CONDITION' | translate}}

In consideration of participating in the Screenland 5K, I agree to assume full responsibility for all risk of bodily injury or loss of life which may result from my participation. I attest and verify that I am physically and mentally able to participate in the Screenland 5K. Furthermore, I hereby agree to hold harmless, release and forever discharge the Culver City Centennial Celebration Committee (CCCCC), the Screenland 5K Committee, the City of Culver City, members of its elected or appointed boards or commissions, its officers, agents, volunteers and employees from any and all liability, claims or demands whatsoever which may arise as a result of my participation.  This Release is intended to discharge in advance the City of Culver City, CCCCC and Screenland 5K Committee, members of its elected or appointed boards or commissions, its officers, agents and employees from and against any and all liability arising out of or connected in any way with my participation in said activities, even though that liability may arise out of negligence or carelessness on the part of the persons or entities mentioned above. I understand that mortal or personal injury and/or property damage can occur as a result of participating in any recreational activity.  Knowing and acknowledging these risks, nevertheless, I hereby voluntarily agree to assume those risks and to release and hold harmless the City of Culver City, members of its elected or appointed boards or commissions, its officers, agents, volunteers and employees from any and all claims or demands whatsoever which may arise as a result of those risks. I give my permission to the City of Culver City, Culver City Centennial Celebration Committee, and Screenland 5K Committee or anyone acting on their behalf to photograph me in this event.  Any of these photographs will become the property of those three entities. I hereby agree that any of these photographs can be used by those entities for publicity and/or promotional purposes and that I will not seek compensation for such use. It is further understood and agreed that this release, assumption of risk, and waiver of publicity rights is to be binding on my heirs, assigns, executors, administrators and any other family members. I agree to accept and abide by the rules and regulations of the City of Culver City, the CCCCC and Screenland 5K Committee

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{{ 'COUNTRY' | translate}}

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{{ 'STREET' | translate}}

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{{ 'CITY' | translate}}

{{ 'PLEASE-PROVIDE-VALUE' | translate}}

{{ 'STATE/REGION' | translate}}

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You're a star in your epic Screenland 5K shirt in the race of the century!  Comfortable unisex cotton blend with limited women's quantities.

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{{ !gigyaLoaded() ? 'MOBILE-DELIVER' : 'FACEBOOK-DELIVER' | translate}}

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{{ 'SUBTOTAL' | translate}} : {{cart.subtotal | currency:"$":currency.decimal}}
{{customFee.description}} : {{customFee.price | currency:"$":currency.decimal}}
{{ 'PROCESSING_FEE' | translate }} : {{cart.fee | currency:"$":currency.decimal}}
{{!cart.hasLottery ? ('TOTAL'|translate) : ('TOTAL_CHARGE_AT_CHECKOUT'|translate)}} : {{cart.total | currency:"$": currency.decimal}}

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{{ 'SUBTOTAL' | translate}} : {{cart.subtotalLottery | currency:"$": currency.decimal}}
{{customFee.description}} : {{customFee.price | currency:"$": currency.decimal}}
{{ 'PROCESSING_FEE' | translate }} : {{cart.lotteryFee | currency:"$": currency.decimal}}
{{ 'TOTAL_CHARGE_IF_SELECTED' | translate}} : {{cart.lotteryTotal | currency:"$": currency.decimal}}
{{ 'IF_SELECTED_CHECKOUT' | translate:cart}}

{{ 'PAYMENT-ERROR' | translate}}

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{{ 'NO-PAYMENT-REQUIRED' | translate }}

{{ 'NAME-ON-CARD' | translate }}

{{ 'REQUIRED' | translate }} {{ 'PAYMENT-NAME-MIN-LENGTH' | translate }}

{{ 'CARD-NUMBER' | translate }}

{{ 'REQUIRED' | translate }} {{ 'INVALID-CREDIT-CARD-NUMBER' | translate }}

{{ 'EXPIRATION' | translate }}

{{ 'REQUIRED' | translate }} {{ 'INVALID-EXPIRATION-DATE' | translate }}

{{ 'SECURITY-CODE' | translate }}

{{ 'REQUIRED' | translate }} {{ 'INVALID-SECURITY-CODE' | translate }}

{{ 'REQUIRED' | translate }}

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{{ 'PAYMENT-INFORMATION-MESSAGE' | translate }}



{{crowdriseTeam.entryName}} Charity Event Fundraising on Crowdrise

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