Run for the Mums 5k Online Registration

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Registrant #1

Who are you registering? *

First Name *

Last Name *

Email Address *

Confirm Email *

Create Password *

This will be the password for your RunSignup account.

Confirm Password *

Date of Birth *

Format: mm/dd/yyyy

Used for age group calculations

Gender *

Male Female

Phone *

Format: ###-###-####

Street Address *

Country *

Zip Code *

City *

State *

Choose Your Event *

5k Run

$25.00 + $3.25 SignUp Fee

(Group Pricing)

Would you like to join or create a Group/Team?

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Waiver

In consideration of the acceptance of my entry, I for myself, my executors, and assignees, do hereby release and discharge Tipp-Monroe
Community Services, Inc., the Mum Festival Committee, the City of Tipp City, Tipp City Police Department, Monroe Township Trustees and
their assignees and sponsors for all claims of damages, demands, actions whatsoever in any manner arriving or growing out of my participation
in said athletic event, I attest and verify that I have full knowledge of the risks involved in this event and I am physically fit and sufficiently
trained to participate in this event.

By checking this box, I agree to the waiver and that I am 18 or older, or that I have the authority to register these participants and agree to the waiver for them, and agree to the Privacy Policy.

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Run for the Mums 5k

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