Run/Walk Registration Form
Run/Walk Date:
July 10, 2027
Location:
Westbrook Park, DeWitt, IA 52742
Start Time:
8:00AM
Run / Walk Group Selection
Select your desired pace/distance group:
*
8 Minute Mile Pace (3 Miles)
10 Minute Mile Pace (2.5 Miles)
12 Minute Mile Pace (2 Miles)
Walking Pace (1.25 Miles)
Event Shirt Size Selection
Select your desired shirt size:
*
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
Adult 2X-Large
Adult 3X-Large
Participant Information
Full Name
*
First Name
Last Name
Age
*
Email
*
example@example.com
Phone Number
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact Details
Contact Person
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Relationship
Waiver & Release
*
I confirm that I am in good shape, health and condition to participate in the Miles of Meaning event.
*
I don't have any medical condition or medical history that will affect my ability to participate in this event.
*
I acknowledge that this run/walk requires physical activity and there are possible risks and dangers associated with participating.
*
I release the Miles of Meaning 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.
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
I would like to remain anonymous and not have my name posted on the event website as a participant.
Payment
Event Fees (includes T-Shirt)
*
prev
next
( X )
USD
Description
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Google Pay
After submitting the form, you will be redirected to Google Pay to complete the payment.
Submit
Print Form
Should be Empty: