Clone of FMCE Leaf Cruncher Registration Form

FMCE Leaf Cruncher 5K and Fun Run

Supporting Education Initiatives in Moffat County
Location: Loudy-Simpson Park, 1009 S. Ranney Street, Craig, CO

Race Date: September 25, 2021

Time: Registration starts at 7:15AM with 5K race set to start at 8:00AM. Fun Run will start at 8:10AM. PLEASE NOTE: MIDDLE SCHOOL CROSS COUNTY RACE BEGINS AT 8:45AM. PARTICIPANTS WILL NEED TO BE OFF COURSE OR MAKE WAY FOR RUNNERS!
Participant Details

Friends of Moffat County Education - Leaf Cruncher 5K and Fun Run
Full Name

First NameLast Name
Age
Date of Birth

MonthDayYear
Date
Email
example@example.com
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
SMLXLXXLChild's SChild's M
Registration Payments
Payment Method
Pay cash or check on race day. Please make checks payable to Friends of Moffat County Education.
Registration Fee
prevnext( X )
Leaf Cruncher 5K$20.00
Entry fee of $20 for all race participants 18 and older.

1 Mile Family Fun Run$ Free
Fun Run is designed for children 12 and under. No charge for the children. Each participant receives a special Elevate Education t-shirt.

Total $0.00
Waiver & Release
I confirm that I am in good shape, health, and condition.I don't have any medical condition or medical history that will affect my participation in this event.I will follow the rule and regulations of the road race event.I acknowledge that this road race requires physical activity and there are possible risks and danger.I release the road race event organizers for any responsibility in case of an accident, illness, or injury.I allow my photo to be taken during the event and used for event advertising and marketing.I confirm that all information in this registration form is accurate and true.
Participant's Signature

Clear
Date Signed

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

Clear
Should be Empty:

FMCE Leaf Cruncher 5K and Fun Run

Participant Details

Registration Payments

Waiver & Release