5K Run Registration Form

MUTT STRUT 5K

Date: April 18 2026

Time:

9:00 AM MDT - Registration
9:30 AM MDT - 5K Start Time
10:00 AM MDT- 1 Mile Fun Run/Walk Start time

Where: Duane Olson Memorial Dog Park

707 W Warner St. Syracuse, Ks 67878
E-mail
example@example.com
Contact Number
Format: (000) 000-0000.
Name

First NameMiddle NameLast Name
T-Shirt Size
*T-Shirt sizes are limited and can only be guaranteed for online registration

Online registration: $20 Adult $15 Youth 6-16

Day of registration: $30 Adult $25 Youth

Children 5 and under free
Let us know how many of your own dogs you will be bringing!
*We cannot guarantee the availability of dogs from the pound that are eligible to participate.
In Case of Emergency
Emergency Contact:

First NameLast Name
Relationship
Contact Number
Format: (000) 000-0000.
Release and Waiver of Liability - Assumption of Risk and Indemnity Agreement
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

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Date
Signature

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Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Should be Empty:

In Case of Emergency

Release and Waiver of Liability - Assumption of Risk and Indemnity Agreement