The Jennifer Mueller Memorial 5k/Fun Run
8:00 AM – 5K Run/Walk. Kids Fun Run to follow.
Runner Details:
Full Name
*
First Name
Last Name
Gender
*
Male
Female
Age as of 7/12/25
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
E-mail
*
example@example.com
Shirt Size
Small
Medium
Large
X-Large
XX-Large
Youth Shirt
X-Small
Small
Medium
Large
X-Large
Waiver of Liability:
*
In consideration of this entry, I the undersigned, intending to be legally bound to myself, heirs, executors and administrators, waive and release any and all rights and claims for damages I may have against The Jenn Mueller Memorial Foundation and St Nicholas Catholic Church and the representatives, successors, assignees and all sponsors for any and all injuries suffered in said event.
Signature (If participant is under 18, parent or legal guardian must sign) *
*
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