This document provides information about registering for a 5K event called "Movin' to the Music" that benefits the Rochester Symphony Orchestra and Chorale. A $25 donation is suggested but not required to participate, and donors of $25 or more will receive a commemorative t-shirt. Registration forms can be sent or brought to Charter House or completed online, and on-site registration is also available on the day of the event. The waiver releases Charter House and event sponsors from liability for any injuries occurring during the event.

1. Movin’ to the Music
5K Waiver and Registration
A $25 Donation to the Rochester Symphony Orchestra and Chorale is
suggested, but not required. Those contributing $25 or more will receive a
commemorative T-Shirt. Checks are made payable to the Rochester Symphony
Orchestra & Chorale. Rochester Symphony Orchestra & Chorale is a non-profit,
federally registered 501(c)(3) organization. $15 tax deductible.
To Register:
Send/bring forms to Charter House: 211 Second Street NW Rochester, MN 55901
Mayo employees can download registration form online at
http://mayoweb.mayo.edu/charterhouse/index.html or
http://mayoweb.mayo.edu/ch-employees/
On-site registration at Silver Lake on June 12th
Call 266-7846 with questions
I agree to participate in the “Movin’ to the Music” 5K walking event. I understand that an event such as this
has the risk of injury from falls or unforeseen events. I certify that I have full knowledge of the risks involved
in this event and I undertake these potential hazards knowingly and at my own risk. I understand that I do
not have to walk the entire 5 kilometers and will participate as safely as possible. I will seek the advice of my
physician if I have any concerns about my ability to participate in this event. If, however, as a result of my
participation in this event, I require medical attention, I hereby give consent and authorize medical personnel
to provide such medical care as deemed necessary. I do hereby agree that I, or anyone acting on my behalf,
will not hold Charter House, its officers and employees, any event sponsors, volunteers, or officials liable in
any way for any claim of injury or loss that might occur as a result of my participation in the event. I further
agree to indemnify Charter House, all event sponsors and any employee, volunteer or official for any
judgments, costs, attorney fees or other expenses incurred by them as a result of any injury to me during the
event.
I have read and agree to the above terms and conditions for the Charter House “Movin’ to the Music” 5K:
Printed name of participant: __________________________________________________________
Signature of participant: ___________________________________________________________________
Date of signature: ________________________________________________________________________
Registration
Name____________________________________________________________
Address__________________________________________________________
City______________________ State__________ Zip Code________________
Email___________________________________ Phone___________________
T-Shirt Size______ (for those donating $25 or more)
MC4342-77