Online Registration

2011 Agape' Celebration and Community Run

Online Registration Is Now CLosed

          

DATE
Saturday, May 14, 2011

LOCATION
Idaho Falls
 John’s Hole Forebay
Idaho Falls - Greenbelt
 

TIME
9 am

DISTANCE
5K Run/ Walk,10K

  

 

  
Contact: Michael Hays   Info Phone: (208) 521-2243

            

Registration Fee (Non-refundable):

Only those registered by Monday, May 1 can be guaranteed tee-shirts in the size requested

Individual: $20.00 Until Monday, March 17

$22.50 Until Thursday, April 15

$25.00 until Friday, May 06

Family: Contact Personal Best Performance directly for a discount

(3 or more living in same household)

Please Enter Participants Information and click below to proceed to a secure credit card processing page. To register more than one participant select the "Add Additional Registration" option after submitting each registration or just click on the "Back Button" in Your Browser to return to this page.

Please notify garydsmith@runwalkjog.com if you experience problems with online registration.  For online registration a processing fee of $2.00 will be added to the registration fee for each participant.

 

2011 Agape' Celebration and Community Run
      
             Last Name:


             First Name:


                  Address:


                        City:


                       State:


                           Zip:


                    Gender:


               Birth Date:


  Age On Event Day:


                       Phone:


                        Email:


                         Shirt: Enter one of the following sizes  S M L XL XXL


         Event Distance:


LIABILITY WAIVER:

If the waiver is not signed the registration will not be accepted

I know that running or walking in a fun run/race is a potentially hazardous activity and that I should not enter and run 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 run. I assume all risks associated with running in this event including, but not limited to: falls, contact with other participants and wildlife, the effects of the weather, including cold and/or rain or snow, traffic and the conditions of the road and path, all such risks being known and appreciated by me. 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 Community Care Fitness Run, City of Idaho Falls, Idaho, PERSONAL BEST Performance, 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:


                                      Signature:


Parent Or Guardian If Under 18:



Online Registration Is Now CLosed

   
Online Payments
   
          
   

Acceptance Mark
 

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