Run With A Mission 5K - 2021 (Individual Registration)

Name

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Phone

Address

Payment $25.00

5 yrs or younger child - free

T-Shirt Size

Adult XL Adult Large Adult Medium Adult Small Child Large Child Medium Child Small

If the above registrant is a minor, I certify that I am a parent or legal guardian and give my permission for the above registrant to participate in the Run with a Mission 5K and assume all the risks involved. I agree

Name of parent/guardian if the participant is a minor

I acknowledge that my participation in the Run with a Mission 5K Fun Run and Walk involves a risk of injury, including bodily injury, and assume the risk for same. On my own behalf and on behalf of my heirs and legal representatives and to the fullest extent permitted by law, I hereby release and discharge Alleluia! Lutheran Church, it's staff, officers, volunteers and members from any and all liability for injury, death, or damages and/or any other claims, demands, losses or damages, incurred by me in connection with any aspect of the 5k run and walk.

I agree

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

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Run With A Mission 5K - 2021 (Individual Registration)

Description

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