5K Sign Up Form

Turkey Trot 5K Sign Up Form

Hosted by Harrison Chapel Cemetery Association
Race Date: November 30, 2024
Location: Macedonia Baptist Church, 8816 Dooley Ferry Rd, Texarkana, AR 71854
Start Time: 8:00 AM
Participant Information

One registration form and waiver per participant
Full Name*

First NameLast Name
Date of Birth

MonthDayYear
Date
Gender
Email
example@example.com
Phone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Virtual or In Person*

Virtual ParticipantIn Person Participant
Pledged Distance*

1 mile2 miles3.1 miles (the entire 5k)
Emergency Contact Details
Contact Person*

First NameLast Name
Phone Number*
Relationship
Waiver & Release
I hereby waive all liability against the Harrison Chapel Cemetery Turkey Trot 5K, HCCA and their staff or representatives and volunteers regarding my participation in the Harrison Chapel Cemetery Turkey Trot. I declare that I am physically fit to participate in this event. I have reviewed all the guidelines. I hereby grant full permission to any and all the foregoing to use any photographs, recordings, or any other record of this event for legitimate purpose.
Participant's Signature*

Clear
Date Signed*

MonthDayYear
Date
Parent/Guardian Signature (If participant is below 18 years old)

Clear
Date Signed

MonthDayYear
Date
Payment Information
My Products*
prevnext( X )
In Person Adult Registration
$25.00



In Person Child (18 or under) Registration
$ Free



Virtual Adult Registration
$20.00



Total

$0.00
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Turkey Trot 5K Sign Up Form

Participant Information

Emergency Contact Details

Waiver & Release

Payment Information