GÖLPHSTOK'S 2026 MUSTACHE RUN
AUGUST 15, 2026
LOCATION:
190 MAPLE STREET
PIERSON, IOWA 51048
SIGN IN: 8:00 - 8:45
A.M.
RUN BEGINS: 9
A.M.
Name
*
First Name
Middle Name
Last Name
Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
*
example@example.com
Contact Number
Format: (000) 000-0000.
Sex
*
Please Select
Male
Female
N/A
Age on Event Date
*
Shirt Size
*
Please Select
Small
Medium
Large
X-Large
XX-L
3XL
In Case of Emergency
Emergency Contact:
*
First Name
Last Name
Relationship
Contact Number
*
Format: (000) 000-0000.
Select your shirt size
Please Select
Small
Medium
Large
XL
2XL
3XL
Release and Waiver of Liability - Assumption of Risk and Indemnity Agreement
In consideration of my participation in the 5K Run, I, the undersigned participant, hereby acknowledge and agree to the following:
I am fully aware of the risks involved in participating in a 5K Run and voluntarily assume all such risks.
I am physically fit and have no medical conditions that would prevent my participation in the 5K Run.
I agree to comply with all rules and regulations of the 5K Run.
I release, discharge, and hold harmless the organizers of the 5K Run, their officers, directors, employees, volunteers, sponsors, and any other persons or organizations associated with the 5K Run from any and all claims, damages, or injuries, including death, that may arise from my participation in the 5K Run or as a result of my use of any facilities or equipment provided by the 5K Run.
Date
*
-
Month
-
Day
Year
Date
Signature
*
*
prev
next
( X )
REGISTRATION FEE
$25.00
$
25.00
Pay with Credit Card
Submit Form
Submit Form
Should be Empty: