MHR 5K Sign Up Form

MHR 5K Sign Up Form
Schedule of Events
Race Date: May 27, 2023

Location: 1100 W 21st, Clovis, NM 88101

Booth Check In: 7:00am

Run Check-In: 7:00am Run Start Time: 7:30

Walk Check-In: 8:30am Walk Start Time: 9:00am
Ealry Registration will end on April 30, 2023. This regiatration time period is to have a t-shirt ordered.

Registration will be open till day of race, however any participants that registar after April 30, 2023 will not be guaranteed a t-shirt.
Participant Information

Name included on registration is required to pick up t-shirts.
Full Name*

First NameLast Name
Age*
Email*
example@example.com
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Disclaimer
You accept that you are entering the Mental Illness Awareness 5k hosted by Mental Health Resources, Inc.and by including your information and clicking the submit button you agree to the following disclaimer;
1. You are medically fit to enter this event and are running/walkig entirely at your own risk
2. Mental Health Resources, Inc. will not be liable for injury, loss, damage and / or death arising from your participation in this event. You waive any claims against Mental Helath Resources, Inc. for (including but not limited to) damage, loss, injury, death whether caused by your participation in this event or third parties who have also entered this event.
3. You accept that the event will involve physical activity and is subject to unpredictable weather and you should take all steps to ensure your own safety
4. You will run/walk within your abilities and will be responsible for any injuries caused by your negligent behavior which result in injuries to others.
5. You will follow any safety rules provided.
6. Mental Health Resources, Inc. is not responsible for your vehicle or the safety of your vehicle when parking and leaving it unattended for your participation in an event.
7. You are willing to be photographed by Mental Health Resources, Inc. and the photographs may be used on our website or for the promotion of future events.

Products*

Walk Registration$20.00

Select a shirt size for each participant registered.

Shirt Size	Quantity
XS
S
M
L
XL
XXL
XXXL
XXXXL

Item subtotal:$0.00

Run Registration$20.00

Select a shirt size for each participant registered.

Shirt Size	Quantity
XS
S
M
L
XL
XXL
XXXL
XXXXL

Item subtotal:$0.00

Exhibitor Booth$50.00

Allows you and your team to set up a booth at the event. 1 tables and 2 chairs provided by MHR.

Quantity
Item subtotal:$0.00

Sponsorship$150.00

*With a booth - Your logo will be on event t-shirts. Logo on a sign around the track. Allows you and your team to set up a booth at the event. 1 tables and 2 chairs provided by MHR. **Without a Booth - Your logo will be on event t-shirts. Logo on a sign around the track.

	Quantity
With Booth
Without Booth

Item subtotal:$0.00

Donation$5.00

Quantity
Item subtotal:$0.00

Total $0.00

Payment Methods

Debit or Credit Card

First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Please click one of the PayPal options to complete payment and submit the form.

Should be Empty:

MHR 5K Sign Up Form

Schedule of Events

Participant Information

Disclaimer