2023-Online 5K registration Form

**Please read all information above about racing in person/virtual, awards, and entry fees**

Name *

First

Last

**Only one person per race entry**

Age (on 5/4/24): *

Gender *

Address *

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Birthdate (mm/dd/yyyy) *

Phone Number *

Email *

If a part of a team, please include team name:

Race: *

• 5K
• Fun Run
• Phantom
• Virtual

How will you be paying for your registration? *

• PayPal
• Debit/Credit Card
• Check/Cash

T-Shirt Size-**T-shirt size and or t-shirts are not guaranteed after 4/26/24** *

• AS
• AM
• AL
• XL
• XXL
• I want a t-shirt, but I DO NOT want a race day bag
• I DO NOT want a t-shirt or a race day bag

**Unless marked, every one that is registered on or before 4/26/24 will receive a t-shirt and race day bag** T-shirts and t-shirt sizes are not guaranteed after 4/26/24**

Race Entry Type *

• Individual Entry - $ 30.00
• Team entry - $ 23.00

Total

$ 0.00

Participant Signature: *

Clear Signature

LIABILITY RELEASE: I, the undersigned, intending to be legally bound, and in consideration of my application for entry into the above-referenced event, hereby for myself, my heirs, executors, administrators, legal representatives, successors and assigns, assume all risks and damages against the Run for the Son 5K, Fun Run, Tot Trot, officers, agents and employees, and all volunteers participating in this event, and agree to hold harmless and indemnify those parties from any claims of any nature arising out of my participation in this event. I acknowledge the inherent dangers of participating in a road race and fully assume the risks associated with same. I further verify that I am physically fit for participation in this event and that I have no condition that would preclude such participation. My execution of this agreement releases the said officers, agents and employees from liability for any act or omission, which causes injury or damage to my person or property related to their organization and operation of this event, and my participation therein. .

Signature of Parent (if under 18)

Clear Signature

Submit

LIABILITY RELEASE:  I, the undersigned, intending to be legally bound, and in consideration of my application for entry into the above-referenced event, hereby for myself, my heirs, executors, administrators, legal representatives, successors and assigns, assume all risks and damages against the Run for the Son 5K, Fun Run, Tot Trot, officers, agents and employees, and all volunteers participating in this event, and agree to hold harmless and indemnify those parties from any claims of any nature arising out of my participation in this event.  I acknowledge the inherent dangers of participating in a road race and fully assume the risks associated with same.  I further verify that I am physically fit for participation in this event and that I have no condition that would preclude such participation.  My execution of this agreement releases the said officers, agents and employees from liability for any act or omission, which causes injury or damage to my person or property related to their organization and operation of this event, and my participation therein.