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Space City 5K Run Registration Form
Welcome to our 2nd annual 5k race! Run for fun or compete for time. We have built a fitness family in our community and would love for you to join us. We are partnering with Anchorage House LLC Foster Care and donating profits towards a better future through health and wellness for our children. Bring your run club, burn some calories, and meet up at Space City Gym in Humble after for FREE CHICK FIL A BREAKFAST & DRINKS for the AWARDS CEREMONY!
DATE: September 7th, 2024. LOCATION: Jesse H. Jones Park, 20634 Kenswick Dr, Humble, TX 77338 TIME: 0800 Competitive Wave, 0830 Standard Wave 0915-0930 CHICK FIL A BREAKFAST @ SPACE CITY GYM
Full Name
*
First Name
Last Name
Age
*
Child Full Name (12 & Under)
First Name
Last Name
Child Age (12 & Under)
Child Full Name (12 & Under)
First Name
Last Name
Child Age (12 & Under)
Standard (medal/shirt only) or Competitive Runner (Eligible for medal/shirt/prize) Top 50 from each category will be awarded medals
*
Standard
Competitive
Team Name
Shirt Size
*
Please Select
S
M
L
XL
E-mail
*
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Contact Number
*
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Number
*
FREQUENTLY ASKED QUESTIONS
Are kids allowed? Yes. AGES 12 & UNDER ARE FREE!!!!! We would reccomend the standard wave.
Are dogs allowed? Yes. Dogs must be well mannered & kept on leash at all times.
What if I have additional questions? Contact us @Spacecitygym on FB/IG
Do I get anything for participating? Yes, each finisher will receive a goody bag, shirt, medal, snacks, water, and top male/female/team winners will receieve an additional prize.
Can I run/walk? Yes
Will there be snacks or refreshments? Yes. Fruit, snacks, & hydration will be provided.
Can my entry be refunded. No. You can donate to our charity and a receipt can be provided.
Will weather cause cancellation? No. Emergency weather may cause race to be delayed or postponed to a safer date/time.
Waiver & Release of Liability
Space City 5k Waiver and Release of Liability. In consideration of being allowed to participate in any way in the Space City 5K Race, the undersigned acknowledges, appreciates, and agrees that:Risks of Participation: The risk of injury from the activities involved in this event is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist.Assumption of Risk: I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the releasees or others, and assume full responsibility for my participation.Compliance with Instructions: I agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately.Release of Liability: I, for myself and on behalf of my heirs, assigns, personal representatives, and next of kin, hereby release, indemnify, and hold harmless Space City Gym, its officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the event (collectively, the “Releasees”), with respect to any and all injury, disability, death, or loss or damage to person or property, whether arising from the negligence of the releasees or otherwise, to the fullest extent permitted by law.Medical Treatment: I authorize the event organizers to secure from any licensed hospital, physician, and/or medical personnel any treatment deemed necessary for my immediate care, and agree that I will be responsible for payment of any and all medical services rendered.Use of Likeness: I grant permission to Space City Gym to use my photograph, video, or other likeness for any legitimate purpose, including advertising and promotional materials, without further notification or compensation.Minors: For participants under the age of 18, a parent or guardian must sign below. By signing, the parent/guardian agrees to the terms of this waiver and consents to the participant’s involvement in the 5K race.I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
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5K Participant
RUN/WALK
$
60.00
Participant(s)
1
2
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Space City 5K TITLE SPONSOR
Title Sponsor - Custom Banner - Social Media Promotions - T-Shirt Logo Placement - 7 Free Entries
$
750.00
Quantity
1
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3
4
5
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Space City Gold Sponsor
Custom Plaque Award Presented to Gold Sponsors -Social Media Promotions - T Shirt Logo Placement -5 Free Entries
$
500.00
Quantity
1
2
3
4
5
6
7
8
9
10
Space City 5K Sponsor
-Social Media Promotions - T Shirt Logo Placement -1 Free Entry
$
150.00
Quantity
1
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5
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9
10
VOLUNTEER
Sign up here & our team will reach out to coordinate your volunteer position. Thank you!
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
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15
FREE ENTRY FOR KIDS 12 & UNDER
$
Free
Quantity
1
2
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***DISCOUNTS AVAILABLE FOR GYMS & RUNCLUB LEADERS
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