Army Ten Miler 2023

2023 Army Ten Miler

Thank you for your interest in participating in the Army Ten Miler on October 8, 2023 with Team Army Ranger. Please note that all requests are on a first come basis and this does not guarantee your slot.
Name*

First Name Middle Initial Last Name
Gender*

MaleFemale
MM/DD/YY*
Email Address*
example@example.com
Phone*
Street Address*
City*
State*
Zip*
Emergency Contact Name*
Emergency Contact Phone number*
Have you run the ATM with Army Ranger Lead The Way Fund before?

YesNo
How many times have you run the Army Ten Miler?*
Adult Performance T-Shirt*

Men'sWomen'sSMLXLXXL (Men's only)
Are you currently, or have you ever, served in the 75th Ranger Regiment?*

YesNo
If yes, please provide Battalions served in and dates of service.
SECTION B: LIABILITY RELEASE & POLICY (COMPLETE ALL FIELDS)
I agree to fundraise $500 on the platform HAKU that Lead The Way Fund has setup or I am responsible for the remaining balance by November 8, 2023.
Army Ranger Lead The Way Fund Policy: In accepting this entry, I hereby for myself and anyone entitled to act on my behalf, waive and release any and all rights to claim for damages I may have against the Lead the Way Fund, Inc. and sponsors for all injuries suffered by me in the 2023 Army Ten Miler. I further attest and certify that I am physically fit and have trained for competition in this event, and a licensed medical doctor has verified my physical condition. I also agree to the fund raising agreement as stated above.
Signature*
Date*

MonthDay Year
Date
Should be Empty:

SECTION B: LIABILITY RELEASE & POLICY (COMPLETE ALL FIELDS)