Registration Form
5K/10K Run / 2 Mile Fun Walk / Kid’s Run
Saturday, June 25th

Start and End at Milbank High School
7:15am - Registration begins
8:00am - 2 Mile Fun Walk
8:15am - 5k
After the 5k - Kid’s Run

Registration fee for 5K/10K and 2 Mile Fun Walk is $20
(You may participate for free but will not receive a T-shirt or be registered for door prizes)

Kid’s Run is Free

  • Kids will receive a certificate of participation

  • 5K/10K prizes awarded per gender age group,
    as well as overall gender winners.

  • Fun Walk will be awarded with door prizes

You must Pre-register by June 12th to be guaranteed a T-shirt!

Event: 5k Run   10k Run   2 mile Fun Walk  Kid’s Run
Name:
Address:
City:
State: Zip:  
Phone:
Email:
For 5K/10K Registration:
Age Group: 12 - 19   20 - 29   30 - 39   40 - 49   50+  
Adult Shirt Size:
Gender: Male   Female
By submitting this form, you agree to the following:

Waiver Release: AGREEMENT, WAIVER, RELEASE AND ACKNOWLEDGEMENT: I acknowledge that it is my responsibility to understand the risks and determine whether I am fit to safely participate in this event and the precautions I should take. I hereby assume full responsibility for my safety and health during this event. I hereby, for myself, my heirs, guardians and personal representatives, forever release, hold harmless, and discharge the Farley Fest 5k Run, its sponsors, directors, volunteers, municipal agencies and beneficiaries, and all other persons and entities associated with the event, (collectively, the "Organizers"), from and against any and all rights and claims for injuries or damages I may sustain or receive arising in any manner from my participation in the event, regardless of whether such injuries or damages result from the negligence of the Organizers. I recognize that the event takes place on open roads and bike trails with many traffic crossings, and regardless of Organizers' efforts to control traffic, I am responsible for my own safety when participating in this event, including when crossing intersections and interacting with moving vehicles. I grant permission to the Organizers to use my name and photograph in brochures and other promotional media without compensation. I acknowledge that the entry fee is non-refundable. If the event is delayed or prevented by any cause outside of the control of the Organizers there shall be no refund of the entry fee or any other costs incurred by me.

Enter Code:
(this code must be entered before submitting)

After Pressing Submit, you will be directed to a page where you can pay online.