Clone of Disney Dash 5K Run/Walk Registration Form

Boot Scootin' 5K & Fun Walk REGISTRATION FORM

**Please submit a form for each individual runner/walker.**
Date: Saturday, May 9, 2026

Packet & Shirt Pick Up: 7:30 AM

Race Start Time: 8:00 AM

Location: Campbell City Park, Campbell, MO

Early Registration is Sunday, April 19, 2026

Join us for the Boot Scootin' 5K and Fun Walk, a fun and family-friendly run/walk benefiting the Campbell Elementary Beta Club's journey to Nationals in Nashville, TN on June 21! This western-themed event is a great way to get moving and give back. Participants are encouraged to dress in their western/Nashville inspired attire—cowboy hats, bandanas, denim, leather, belt buckles, boots welcome! All proceeds will benefit our the Campbell Elementary Beta Club attend National Beta Convention in Nashville, TN.

The National Beta Club is a student organization dedicated to recognizing and fostering excellence in academics, leadership, character, and service. For local students, it offers opportunities to grow as leaders, serve their community, and build lifelong friendships while preparing for future academic and career success.

This race is a self-timed event, meaning more of your regsitration fee directly supports our elementary students at National Beta Convention.

** Can't make it in person on May 9? Participate virtually! Every step helps send our students to Nationals in Nashville! 💙

*RACE DAY DETAILS*

Run/ Fun Walk
- Awards for Top 3 Fastest 5K Runners (Male, Female, Youth) 🏅
- Awards for Best Boot Scootin', Nashville, Country Western Inspired Costumes (Adult, Youth, Group) 👑
- Walkers & strollers welcome – No pets, please
- Nashville Inspired stops for water and motivation along the way
Choose Registration Type -
Name

First NameMiddle 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.
Age on Event Date
Birthdate
In Case of Emergency
Emergency Contact:

First NameLast Name
Relationship
Contact Number
Format: (000) 000-0000.
Registration- Register by April 19 to Guarantee Event Shirt & Best Price
Choose all that apply. *
prevnext( X )
5K - Register by April 19 for shirt & best price!
Includes Shirt & Participation Medal

$25.00 Quantity
Item subtotal:$0.00



Virtual 5K - Register by April 19 for shirt & best price!
Includes shipped Disney Dash 5K Shirt, Participation Medal, Certificate of Support

$35.00 Quantity
Item subtotal:$0.00



1-3 Mile Fun Run/Walk
**No Shirt Included

Come show your support for Campbell Elementary Beta & Participate in the dress up awards and other fun!

$10.00 Quantity
Item subtotal:$0.00



5 & Under Participants
**No Shirt Included

$ Free Quantity
Item subtotal:$0.00



Boot Scootin' Shirt
*Extra Shirt

$20.00 QuantitySize
Item subtotal:$0.00



Event Sponsorship Registration Only
Choose this option to register a runner through your Event Sponsorship Spots. For more information about sponsoring the Beta 5K and receiving 5K registration through your sponsorship, email us at cesbetaboosters@gmail.com

$ Free Quantity



Total

$0.00
EVENT T-SHIRT - Register by April 19 to Guarantee Event Shirt
Choose Your Shirt Size for 5K
Total Amount Due & Payment
If you chose "Event Sponsorship Registration Only" above, please list the business/organization sponsorship you are registering under here.
Type your total amount due here. Please include cost of registration and any additional costs for shirt.
PayPal - Submit PayPal Payment to @cesbetaboosters (Please send as Friends & Family Only)Cash / Check - Please send cash or check in a sealed envelope with a Campbell Student to turn in to the HS/Elementary School Office - Attention Brittany Crane/ Beta 5K Registration Fee
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

MonthDayYear
Date
Signature

Clear
Submit registration form and payment to:

Campbell Elementary/hs Office - via student

Paypal @cesbetaboosters via Friends & Family and submit online form

Questions? email cesbetaboosters@gmail.com or call/text 573-500-1484

Registration is nonrefundable and nontransferable. Once entry is received no refunds will be given if you cannot participate, or if the event is cancelled due to weather, natural disaster, or other unforeseen circumstances.
Should be Empty:

Boot Scootin' 5K & Fun Walk REGISTRATION FORM

In Case of Emergency

Registration- Register by April 19 to Guarantee Event Shirt & Best Price

EVENT T-SHIRT - Register by April 19 to Guarantee Event Shirt

Total Amount Due & Payment

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