First Name:

                  Address:

                        City:

                       State:

                           Zip:

                     Gender: Choose One Male Female

               Birth Date:

  Age On Event Day:

                       Phone:

                        Email:

                        Event:   Select One 5K Run 5K Walk 1 Mile

                   Shirt Size: Choose One Small Medium Large X Large XX Large

LIABILITY WAIVER:

I know that participating in a walking, jogging, running, event is a potentially hazardous activity and that I should not enter and complete unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the event. I assume all risks associated with participating in this event including, but not limited to: falls, contact with other participants and wildlife, the effects of the weather, including heat, cold and/or rain or snow, traffic and the conditions of the road, path, or trail, all such risks being known and appreciated by me. By circling the Butt In Gear logo on the top of this form I enter a special drawing. Having read this waiver and knowing these facts and in consideration of your accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release the organizers of the selected event or events, the State of Idaho, all cities, BLM and counties, Butt In Gear, and all other sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event or carelessness on the part of the persons named in this waiver. Further, I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for legitimate purposes.

  
                                          Waiver: Choose One Yes

                                      Signature:

Parent Or Guardian If Under 18:

Enter Amount Below, If you would like to make a donation pledge to the Go Me 5K My Way.  Leave blank if you do not wish to make a donation.

  Donation Pledge: For the Go Me 5K My Way.  Please bring pledges to event.

Online Registration Is Now Closed