HCCAA 5K Registration Form

HCCAA 5K RUN/WALK Registration Form 13.06.26

Please fill out your personal details to register.
Collect your 5K package on 06.06.26 & 07/06.26 between 8.00am and 12.00 noon or on 12.06.26 between 3.30pm and 6.30pm at Holy Cross College carpark.
Closing Date for Registration

MonthDayYear
Date
Hour MinutesAM/PM Option
Link to route - https://www.plotaroute.com/route/3290433?units=km
Route QR Code
Name*

First NameLast Name
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Is there any medical issue which will put you at risk?*

YesNo
Brief description (Optional)
Signature*

Please sign to acknowledge the liability release.
LIABILITY RELEASE: I am voluntarily entering and/or attending the 5K event. I agree not to enter and/or attend the 5K event unless I am medically able. I agree to abide by any decision of the 5K coordinators regarding my ability to safely complete the 5K event. I recognise that attendance at and/or participation in the 5K event is a potentially hazardous activity, and I willingly assume all risks associated with such participation, including but not limited to falls, contact with other participants, spectators. or others, effects of the weather, including heat and/or humidity, wind. cold, and wet or slippery surfaces, falling branches or other overhead objects and the crowded nature of the event, all such risks being known and appreciated by me. In consideration of being accepted as an attendee and/or participant in the 5K, I, for myself and anyone entitled to act on my behalf, do hereby release, waive, discharge, hold harmless, and covenant not to sue: Holy Cross College Board of Management, Holy Cross College Alumni Association and the Arima Borough Corporation and all sponsors and any employees, volunteers, including medical or nursing personnel, other representatives, agents, and successors of each of the foregoing from present and future claims and liabilities of any kind, known and unknown, arising out of my participation in the 5K event, even though such claim or liability may arise out of negligence or fault on the part of any of the covenanted persons referenced herein. I grant permission to all of the foregoing to use my photographs which I may share online as part of the event, personal data provided during registration and post-event reporting, video or audio recordings, or any other record of this event for any legitimate purpose. I understand that this event does not provide for refunds in the event of a cancellation, and by signing this waiver, I consent that I am not entitled to a refund if the event is cancelled before or during the event.
Date*

MonthDayYear
Date
ID/DP
Please enter your ID/DP information.
Age Ranges*
Gender*
Select T-Shirt Size*
Signature ....................................................................................................Date.......................................

Registration Details

Rows	Name	Phone Number	Address	Email Address	Age Ranges	Medical Issue	Brief Description	Signature	Date	ID/DP	Closing Date for Registration	Male	Female	Volunteer	Payment made
Registrant 1
Registrant 2
Registrant 3

Participant Category*

RUNNERWALKERVOLUNTEER
Payment Category*

Student under-18 $50.00TTHCC Student & T-Shirt $50.00TTStudent under-18 & T-Shirt $100.00TTOther $150.00TTOther & T-Shirt $200.00Volunteer $0.00
Name of School*
Parental Consent for Student under-18 - Name of Parent*
DP/ID of Parent- state which*
Signature of Parent*
Payment Options
Select Proof of Payment mode used
Should be Empty:

HCCAA 5K RUN/WALK Registration Form 13.06.26