5K Entry Form

Racer 1
Name*

First NameLast Name
Gender*

MaleFemale
Race Day Age*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Please check here if you are running VIRTUALLY and submitting your time via email.

Virtual Run / Email Time
Racer Information*
INCOMPLETE OR UNSIGNED ENTRY FORMS WILL NOT BE ACCEPTED

In consideration of my entry being accepted, I intend to be legally bound, and do hereby for myself, my heirs and executors waive all rights and claims for damages which may hereafter accrue to me against Central Florida Striders, Parkview Pre-K, LLC, Parkview Estates, Inc., Parkview Prep Academy, or any of its respective officers, race officials, sponsors, or agents for all claims or liabilities of my participation in this event even though that liability may arise out of negligence on the part of any person named in this waiver. If I should suffer an injury or illness, I authorize the officials of the race to have me transported to a medical facility, and I take full responsibility for this action. I attest and verify that I am physically fit to participate in this event.
Participant's Signature (Parent/Guardian if under age 18)*

Powered by Jotform SignClear

Racer 2
Name*

First NameLast Name
Gender*

MaleFemale
Race Day Age*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Please check here if you are running VIRTUALLY and submitting your time via email.

Virtual Run / Email Time
Configurable list*
INCOMPLETE OR UNSIGNED ENTRY FORMS WILL NOT BE ACCEPTED

In consideration of my entry being accepted, I intend to be legally bound, and do hereby for myself, my heirs and executors waive all rights and claims for damages which may hereafter accrue to me against Central Florida Striders, Parkview Pre-K, LLC, Parkview Estates, Inc., Parkview Prep Academy, or any of its respective officers, race officials, sponsors, or agents for all claims or liabilities of my participation in this event even though that liability may arise out of negligence on the part of any person named in this waiver. If I should suffer an injury or illness, I authorize the officials of the race to have me transported to a medical facility, and I take full responsibility for this action. I attest and verify that I am physically fit to participate in this event.
Participant's Signature (Parent/Guardian if under age 18)*

Powered by Jotform SignClear

Racer 3
Name

First NameLast Name
Gender

MaleFemale
Race Day Age
Address

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Please check here if you are running VIRTUALLY and submitting your time via email.

Virtual Run / Email Time
Configurable list
INCOMPLETE OR UNSIGNED ENTRY FORMS WILL NOT BE ACCEPTED

In consideration of my entry being accepted, I intend to be legally bound, and do hereby for myself, my heirs and executors waive all rights and claims for damages which may hereafter accrue to me against Central Florida Striders, Parkview Pre-K, LLC, Parkview Estates, Inc., Parkview Prep Academy, or any of its respective officers, race officials, sponsors, or agents for all claims or liabilities of my participation in this event even though that liability may arise out of negligence on the part of any person named in this waiver. If I should suffer an injury or illness, I authorize the officials of the race to have me transported to a medical facility, and I take full responsibility for this action. I attest and verify that I am physically fit to participate in this event.
Participant's Signature (Parent/Guardian if under age 18)

Powered by Jotform SignClear

Racer 4
Name

First NameLast Name
Gender

MaleFemale
Race Day Age
Address

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Please check here if you are running VIRTUALLY and submitting your time via email.

Virtual Run / Email Time
Configurable list
INCOMPLETE OR UNSIGNED ENTRY FORMS WILL NOT BE ACCEPTED

In consideration of my entry being accepted, I intend to be legally bound, and do hereby for myself, my heirs and executors waive all rights and claims for damages which may hereafter accrue to me against Central Florida Striders, Parkview Pre-K, LLC, Parkview Estates, Inc., Parkview Prep Academy, or any of its respective officers, race officials, sponsors, or agents for all claims or liabilities of my participation in this event even though that liability may arise out of negligence on the part of any person named in this waiver. If I should suffer an injury or illness, I authorize the officials of the race to have me transported to a medical facility, and I take full responsibility for this action. I attest and verify that I am physically fit to participate in this event.
Participant's Signature (Parent/Guardian if under age 18)

Powered by Jotform SignClear

Payment & Submit
Parkview Student Receiving Credit*
If none, please write N/A
Total Due:*
Payment Method*

CashCheck (Make checks payable to: Parkview Prep Academy)QuickBooks Invoice (3% convenience fee)