Please fill out the form for FREE entry.

Child's Information
First Name
Last Name
Date of Birth
Age on Oct 1st
Gender
Parent/Guardian Information
First Name
Last Name
Email
Street Address
City
State
Zip
Primary Phone
Waiver

I have read and understand the Waiver policy below.
WAIVER: In consideration of my application and permitting me to participate in this event, I hereby take action for myself and anyone entitled to act on my behalf: Waive, release and discharge from any and all liability from my death, disability, personal injury, property damage, property theft or actions of any kind which might hereafter accrue to me including my traveling to and from the event, THE FOLLOWING ENTITIES OR PERSONS: event coordinator, event director, event committee; The United States Government; Harpers Ferry National Historical Park, Antietam National Battlefield, C & O Canal National Historical Park, The Town of Shepherdstown, Shepherd University, volunteers, event sponsors, their directors, officers, employees, volunteers’ representatives, and agents, and the event holders. I hereby agree to indemnify and hold harmless the entities or person mentioned in this paragraph from any and all liability or claims made as a result of participation in this event, whether caused by the negligence or releases or otherwise.