Heron's Flight: 5K Run Registration

5K Fun Run/Walk Registration Form
Event Date: Saturday, April 26, 2025

Time: 10 AM - 12 PM
Location: Glide Athletic Fields

Join us for the Heron’s Flight Fun Run! Whether you run or walk, you're supporting community wellness and compassionate nursing scholarships.
Your Information
Full Name*

First NameLast Name
Birth Date*

MonthDayYear
Run or Walk*

RunnerWalker
Flight Time*

Flight 1 - 10:30 AM
E-mail*
example@example.com
Contact Number*
Emergency Contact*

First NameLast Name
Emergency Contact Number*
Please enter a valid phone number.
Emergency Contact Relationship
Billing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Do you have additional entries?

YesNo

Additional Entries
Full Name*

First NameLast Name
Birth Date*

MonthDayYear
Run or Walk*

RunnerWalker
Emergency Contact

First NameLast Name
Emergency Contact Number
Please enter a valid phone number.
Emergency Contact Relationship
Full Name

First NameLast Name
Age
Run or Walk

RunnerWalker
Emergency Contact

First NameLast Name
Emergency Contact Number
Please enter a valid phone number.
Emergency Contact Relationship
Full Name

First NameLast Name
Age
Run or Walk

RunnerWalker
Emergency Contact

First NameLast Name
Emergency Contact Number
Please enter a valid phone number.
Emergency Contact Relationship
Full Name

First NameLast Name
Age
Run or Walk

RunnerWalker
Emergency Contact

First NameLast Name
Emergency Contact Number
Please enter a valid phone number.
Emergency Contact Relationship

Waiver & Agreement
I understand that participation in the Heron’s Flight 5K Fun Run/Walk involves physical activity, and I assume all risks associated with this event. I release organizers, sponsors, and volunteers from any liability.*

Check Here to Agree
I agree that any photos or videos taken during the event may be used for promotional purposes.*

Check Here to Agree
Signature*

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Sign here to verify your consent to the previous waivers and agreements.

Payment

Registration Type

5K Run/Walk Fee - AdultAll funds go to supporting the education of compassionate nurses in Douglas County.

$10.00 Quantity

5K Run/Walk Fee - YouthAll funds go to supporting the education of compassionate nurses in Douglas County.

$5.00 Quantity

Donation to Carmen Bernal Compassionate Nursing Scholarship Product Image

Donation to Carmen Bernal Compassionate Nursing ScholarshipSupport future nurses who embody kindness and dedication to patient care. Your donation helps aspiring healthcare professionals continue her legacy. All donations are tax deductible. EIN: 82-3265082

$25.00 Quantity

Enter coupon

Total

$0.00

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5K Fun Run/Walk Registration Form

Your Information

Additional Entries

Waiver & Agreement

Payment