Prairie Days Festival 5K Totally Tubular 5K Run Form

Participant Information *

First NameLast Name
Phone Number*
E-mail*
example@example.com
Registration - on or before September 26, 2024*

Adult 18+ - $30.00Youth under 18 - $20.00
Late Registration - October 1, 2024

Adult 18+ - $35.00Youth under 18 - $25.00
T-Shirt Size (2XL and up, please add $4.50 to total)*

SMLXLXXLOther
Waiver & Release*

I confirm that I am in good shape, health, and condition.I don't have any medical condition or medical history that will affect my participation in this event.I acknowledge that this road race requires physical activity and there are possible risks and danger.I release the race event organizers for any responsibility in case of an accident, illness, or injury.I confirm that all information in this registration form is accurate and true.
Signature*

Clear
Date*

MonthDayYear
Date

Total Amount Due*

USDDescription