5K Walk and Family Fun Day

5K Walk and Family Fun Day Registration Form
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* Indicates required field

Participant Name *

First

Last

Parent/Guardian Name if Under 18: *

First

Last

DOB required if under 18 (mm/dd/yy) *

Gender *

Email *

Phone Number *

Church Affiliation *

Other Church's name *

Check Box *

Waiver of Liability (Check box for consent): In consideration of my entry being accepted and by signing below, I waive any and all claims for myself, my administrators, and my heirs against all officials, sponsors, and organizations connected with the Walk for injury or illness that may directly or indirectly result from my participation in this event. I attest that I have full knowledge of the risks involved in this event, and am physically fit and sufficiently trained to participate in this event. Furthermore, I hereby grant full permission to take and use any photographs taken during the event race in which I may appear for any legitimate reason that may include future advertising and promotion.

By registering, you agree to pay the $35 entry fee. Your registration is incomplete until you complete your payment.

Sign below by printing name (parent/guardian must complete if under 18) *

Submit Registration

5K Walk and Family Fun Day Registration FormPlease use Chrome or Edge browsers (Don't use Safari)

5K Walk and Family Fun Day Registration Form
Please use Chrome or Edge browsers (Don't use Safari)