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Step 1 of 2 - Participant Registration |
First Name | Last Name
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Address 1
| Address 2
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City
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State / Province
Use 2 digit code for US and Canada otherwise, leave blank. ![[Canadian Flag]](../images/flags/smCanada.gif) | Country (only if outside of the U.S. and Canada)
Leave blank if address is within US or Canada. |
Zip / Postal Code
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Primary Phone Number
Required... please provide your primary number. | Other Phone
Optional... you may provide an alternate phone number in the unlikely event of an emergency. |
Email Address
Participant's active Email Address... check for accuracy. |
Participant's Date of Birth
| Sex
Gender: M for Male, F for Female. |
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| | | | Apparel Description Note: 5k registration fee includes a race shirt | FunRun registration fee does not include a shirt (added cost); if you don't want a shirt just select "No Shirt" below.
2XL and 3XL sizes are also available for an additional $5.00. | | | | |
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Shirt Selection
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How Did You Learn of Junior Achievement 5k and Fun Run?
Optional... make our race better by letting us know how you learned of Junior Achievement 5k and Fun Run. Example: "I ran last year", "I saw neighborhood sign / flyer", "I received email notification", "I was referred by friend". |
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Charitable Donation:
Optional... please consider an additional charitable donation. Junior Achievement provides financial literacy, work readiness, and entrepreneurship to students in all grade levels from K-12. |
Waiver
I know that running a road race is potentially hazardous. I should not enter and run or walk unless I am medically able and properly trained. I agree to abide by any decision of race officials relative to my ability to safely complete the run or walk. I assume all risks associated with running in this event including, but not limited to: falls, contact with others, weather effects, including heat or humidity, traffic and the condition of the road, all such risks being known and appreciated by me. For my safety, I understand that bicycles, skateboards, roller skates/blades and animals are not allowed in the 5k race and I will abide by this guideline. Having read this waiver and knowing these facts and in consideration of you accepting my entry, I for myself and anyone entitled to act on my behalf waive and release Junior Achievement serving North Manchester and all the named sponsors, and all their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I also understand that no refunds will be given for any reason.
If Under 18: My parent/guardian has read the above waiver ... and by clicking on the box below, agrees to all of the conditions noted therein. Agree to waiver by checking here.By agreeing to this waiver you submit to the terms and conditions as set forth by this event and certify that you have provided true and accurate information as requested through this registration process. |
Coupon Code
Do you have a coupon or promo code? If so, please include it here. |
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