5K RUN REGISTRATION FORM
Date: October 4, 2025 Registration 7-7:45 AM Run: 8:00 AM Venue: American Bank @ 243 S Market St, Goliad, TX 77963
Name
*
First Name
Middle Name
Last Name
Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
*
example@example.com
Contact Number
*
In Case of Emergency
Emergency Contact:
*
First Name
Last Name
Relationship
*
Contact Number
*
Age Group on Event Day
Please Select
6th Grade and Below $5-Male
6th Grade and Below $5-Female
7th-12th Grade $5-Male
7th-12th Grade $5-Female
Adults $10
GISD Staff Member $10
Cash or Check Only
All Proceeds will be donated to the Agriculture Teachers Association of Texas Crisis Fund
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.
Date
*
-
Month
-
Day
Year
Date
I
blanks
approve all of the above information to be true and consider this as my signature.
Submit Form
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