Hopeful Hearts 5K Registration Form
Saturday August 3rd
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Age on event date
Emergency Contact
Emergency Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Shirt Size
Release and Waiver of Liability - Assumption of Risk and Indemnity Agreement
In consideration of my participation in the 5k Run, I, the undersigned participant, hereby acknowledge and agree to the following:
I am fully aware of the risks involved in participating in a 5K Run and voluntarily assume all such risks.
I am physically fit and have no medical conditions that would prevent my participation in the 5K Run.
I agree to comply with all rules and regulations of the 5K Run.
I release, discharge, and hold harmless the organizers of the 5K Run, their officers, directors, employees, volunteers, sponsors, and any other persons or organizations associated with the 5K Run from any and all claims, damages, or injuries, including death, that may arise from my participation in the 5K Run or as a result of my use of any facilities or equipment provided by the 5K Run.
Signature
Please send payment to: $25
Paypal @HopefulHearts374 Cashapp $hh0824 Venmo @lweaver8605
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