VegRun Sign Up Form

VegRun Sign Up Form
Event Date: October 21, 2023
Location: Sugar Land Memorial Park Pavilion (South Meadow)
Start Time: 7:00 - 11:00 AM
Participant Information
Full Name*

First NameLast Name
Age Group*
Gender*
Email*
example@example.com
Buddha's Light International Association (B.L.I.A) Member?*

YesNo
Phone Number*

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact Details
Contact Person*

First NameLast Name
Phone Number*

Area CodePhone Number
Relationship
Payment Information
Fees*
prevnext( X )
Registration Fee$10.00

Quantity
Item subtotal:$0.00

Event T-Shirt (Optional)$10.00

Quantity

Total $0.00
T-Shirt Size

XSSMLXLXXL
Method of Payment
Waiver & Release
In consideration of my participation in the VegRun, I, the undersigned participant, hereby acknowledge and agree to the following:*

I am fully aware of the risks involved in participating in a VegRun and voluntarily assume all such risks.I am physically fit and have no medical conditions that would prevent my participation in the VegRun.I agree to comply with all rules and regulations of the VegRun.I release, discharge, and hold harmless the organizers of the VegRun, their officers, directors, employees, volunteers, sponsors, and any other persons or organizations associated with the VegRun from any and all claims, damages, or injuries, including death, that may arise from my participation in the VegRun or as a result of my use of any facilities or equipment provided by the VegRun.
Participant's Signature*

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Date Signed*

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

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Date

MonthDayYear
Date
Should be Empty:

VegRun Sign Up Form

Participant Information

Emergency Contact Details

Payment Information

Waiver & Release