5K Sign Up Form

Race Date: Saturday October 25, 2025
Location: York Prep, 1047 Golden Gate Ct, Rock Hill SC 29732
Start Time: Packet Pickup begins at 7:30 am
Race begins at 9:00 am
Awards Ceremony at 10:00 am

Date of Birth

Date

Full Name

First NameLast Name

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Email

example@example.com

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My Products*

Registration Fee$25.00

Join York Prep on Saturday, October 25th for our Patriot 5K Run/Walk! Families, staff, and the community are invited for an exciting COSTUME race around campus! Funds raised from the event will contribute to a Scholarship Fund which will be awarded to a 2026 graduate! Costumes are encouraged but not required.

Quantity

5K Sleep In Supporter$25.00

Join York Prep on Saturday, October 25th for our Patriot 5K Run/Walk! Families, staff, and the community are invited for an exciting COSTUME race around campus! Funds raised from the event will contribute to a Scholarship Fund which will be awarded to a 2026 graduate! Costumes are encouraged but not required.

Quantity

Total $0.00

Credit Card

Waiver*

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 eventI acknowledge that this road race requires physical activity and there are possible risks and danger.I confirm that all information in this registration form is accurate and true.I consent to have my picture taken and shared on YPA's social media channels.

Participant's Signature

Date Signed

Date

Parent/Guardian Signature (If participant is below 18 years old)

Date

2025 Patriot 5K Sign Up Form

Participant Information

Emergency Contact Details

Payment Information

Credit Card

Waiver & Release