5k/10k Race

Name *

Phone *

Address *

Address Line 1

City

State

Zip Code

Email *

Gender *

Male
Female

T-Shirt Size: *

Medium
Large
X Large
XX Large

Event: *

10K Run
5K Run
5K Walk

Age on race day *

In consideration of your acceptance of my application for entrance in the Scottdale Fall Festival 10K Run/ 5K Walk / 5K Run, I, for myself and anyone entitled to act on my behalf, waive and release the Scottdale Fall Festival, all Sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event.

Signature - (please type your name) *

Date / Time *

Please note once you complete the form and hit the submit button, you will be directed to PayPal to complete payment.

Name

5k/10k Race

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