Fun Run Registration Form 2025

Parent/Guardian*

First NameLast Name

Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

E-mail*

example@example.com

Contact Number*

Format: (000) 000-0000.

Participant #1*

First NameLast Name

Participant # 1 Shirt Size*

Do you have another participant you would like to sign up for the Fun Run?*

YesNo

Participant #2

First NameLast Name

Participant # 2 Shirt Size

Do you have another participant you would like to sign up for the Fun Run?

YesNo

Participant #3

First NameLast Name

Participant # 3 Shirt Size

Do you have another participant you would like to sign up for the Fun Run?

YesNo

Participant #4

First NameLast Name

Participant # 4 Shirt Size

Do you have another participant you would like to sign up for the Fun Run?

YesNo

Participant #5

First NameLast Name

Participant # 5 Shirt Size

Do you have another participant you would like to sign up for the Fun Run?

YesNo

Participant #6

First NameLast Name

Participant # 6 Shirt Size

Emergency Contact:*

First NameLast Name

Contact Number*

Format: (000) 000-0000.

Relationship*

In consideration of my participation in the Warrior Fun Run, I, the undersigned participant, hereby acknowledge and agree to the following:*

In consideration for permission to participate in the Warrior Fun Run, I hereby HOLD HARMLESS the Smithville R-II School District, their officers, agents, or employees from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, damage, or injury, while participating in any VOLUNTARY Activity, while in, on or upon the premises where the activities are being conducted.I understand that the Smithville R-II School District does not require me to participate in this activity.I, the undersigned, being aware of my own health and physical condition, and having knowledge that participation in any exercise program may be injurious to my health, am voluntarily participating in physical activity of my own free will. Although accidents are rare, I am fully aware of and appreciate the risks, including the risk of catastrophic injury, paralysis, even death, as well as damages associated with participation. I hereby release Smithville RII School District and any person working on behalf of the school district from liability for accidental injury or illness which I may incur as a result of participating in the said physical activity. I hereby assume all risks connected therewith and consent to participate in said program. I hereby waive and release any and all claims which may be made against Smithville RII School District and any person working on behalf of the District.

Name*

First NameLast Name

I HEREBY VERIFY BY MY SIGNATURE THAT I FULLY UNDERSTAND AND ACCEPT EACH OF THE CONDITIONS FOR PARTICIPATION IN ACTIVITIES AT SMITHVILLE SCHOOL DISTRICT.

Signature*

Date*

Date

In Case of Emergency

Release and Waiver of Liability