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| Step 1 of 2 - Family Registration |
Head of Family's First Name
| Last Name
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Address 1
| Address 2
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City
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State / Province
Use 2 digit code for US and Canada
otherwise, leave blank.
![[US Flag]](images/flags/smUSA.gif) ![[Canadian Flags]](images/flags/smCanada.gif) | Country, if outside of the U.S. and Canada
Leave blank if address is in US or Canada. |
Zip / Postal Code
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Primary Phone Number
Required... please provide your primary number. | Other Phone
Optional... provide an alternate phone number. |
Email Address
Your active Email Address... check for accuracy. |
Head of Family's Date of Birth
Format: YYYY-MM-DD | Sex
M for Male, F for Female. |
Previous Participation in JA FunFest Race
Help make our race better... please indicate your participation in our past JA FunFest races. |
Participation in Last Year's JA FunFest Race
Help make our race better... please indicate your participation in last year's JA FunFest race. |
Do you run other races besides our JA FunFest Race?
Help make our race better... please indicate your participation in races other than our annual JA FunFest race. |
How did you hear about our JA FunFest race?
Optional... help make our race better by letting us know how you found us.
Example: "I ran last year", "saw neighborhood sign / flyer", "received email notification", "referred by friend" |
Charitable Donation
Optional... please consider an additional charitable donation. Junior Achievement is a 501(c)(3) entity that empowers students with knowledge about their roles as producers and consumers and their personal impact on society. Please consider an additional 100% tax deductible contribution (any amount). |
Number of Runners for Your Family (2 to 6)
Total number of runners for your family... You plus the number of your family members.
Example... Let's say your family is made up of you, your spouse, and two children.
You + Spouse + 2 = 4 |
Waiver
I know that running a road race is potentially hazardous. I should not enter and run or walk unless I am medically able and properly trained. I agree to abide by any decision of race officials relative to my ability to safely complete the run or walk. I assume all risks associated with running in this event including, but not limited to: falls, contact with others, weather effects, including heat or humidity, traffic and the condition of the road, all such risks being known and appreciated by me. For my safety, I understand that bicycles, skateboards, roller skates/blades and animals are not allowed in the 5k race and I will abide by this guideline. Having read this waiver and knowing these facts and in consideration of you accepting my entry, I for myself and anyone entitled to act on my behalf waive and release the FunFest 5k and all the named sponsors, and all their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I also understand that no refunds will be given for any reason.
If Under 18: My parent/guardian has read the above waiver ... and by clicking on the box below, agrees to all of the conditions noted therein.
By agreeing to this waiver you submit to the terms and conditions as set forth by this event and certify that you have provided true and accurate information as requested through this registration process. |
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