5K Sign Up Form

My Registrations:

Regular Registration $ 45.00

Ages 13+ (under 14yo see youth registration)

Quantity

Youth Registration $ 25.00

Ages 5-13

Quantity

Total $ 0.00

Waiver & Release
By signing below I agree that:

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 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 confirm that all information in this registration form is accurate and true. I authorize Success Fitness to use any photos taken at the event for future purposes both printed and web-based. My race registration is non-refundable My race registration is transferable up to 7 days prior to the event.
Participant's Signature

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Date Signed

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

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Date

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Date
Should be Empty:

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Participant Information