MHR 5K Sign Up Form

MHR 5K Sign Up Form
Schedule of Events
Participant Information

Name included on registration is required to pick up t-shirts.
Race Date: Rescheduled for July 15th

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
***Due to rescheduling registration has been reopened. New registration deadline is July 8th 2023. Register soon! Not all new reistrants are guaranteed a t-shirt. Extra t-shirts were originally ordered.

Ealry registration previously ended on April 30, 2023. That regiatration time period was to have a t-shirt ordered.

Registration will be open untill the day of the race, however any participants that register after April 30, 2023 will not be guaranteed a t-shirt.
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

Donation$5.00

Quantity
Item subtotal:$0.00

Total $0.00

Payment Methods

Debit or Credit Card

First Name

Last Name

Credit Card Number

Card Expiration

Security Code

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