5K Color Run/Walk | Randolph County Fair

First name

Last name

Birthday

Month

Day

Year

Address

Phone

Team Name (if registering in a group of 4 or more)

I certify that I suffer no conditions likely to cause injury or illness to myself from participating in this event.

I waive and release all rights I may have against the Randolph County Fair, Camp Pioneer and the 5K Committee for damages, injuries, or losses I may suffer as a result of this event.

I grant permission to the Randolph County Fair to use my name, photograph and/or videotape of this event without limitation or obligation.

Signature and date

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If contestant under 18 years old, name of parent/guardian

Signature of Parent/Guardian if contestant under 18 years old and date

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5K Registration

13 and Older Participant$25

12 and Under Participant$20

Adult Groups of four or more (price is per participant--add one for each)$20

Transaction Fee$2

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