PRAIRIE DAYS FESTIVAL
Participant Information
*
First Name
Last Name
Phone Number
*
Format: (000) 000-0000.
E-mail
*
example@example.com
Registration - on or before October 1, 2024
Adult 18+ - $30.00
Youth under 18 - $20.00
Late Registration - October 1, 2024
Adult 18+ - $35.00
Youth under 18 - $25.00
T-Shirt Size (2XL and up, please add $4.50 to total)
*
S
M
L
XL
XXL
Other
Waiver & Release
*
I confirm that I am in good shape, health, and condition.
I don't have any medical condition or medical history that will affect my participation in this event.
I acknowledge that this road race requires physical activity and there are possible risks and danger.
I release the race event organizers for any responsibility in case of an accident, illness, or injury.
I confirm that all information in this registration form is accurate and true.
Signature
*
Date
*
-
Month
-
Day
Year
Date
Total Amount Due
*
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USD
Description
Credit Card
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