Iredell County Young Life Camp Run
May 13th, 9:13 am
Sign up here - Every Dollar goes directly to a camper having the best week of their lives this summer!

Registration Fees
Adults and Kids:  $25
Family Registration: $100
Students with 4 sponsoring runners run free.
Campers who have deposits in run free.

Location
Arts & Science Musem Trail 1335 Museum Drive, Statesville, NC  28677
 
Awards
Sign up by May 1 to guarantee a finisher medal.
Additional awards for top 3 in male/female age brackets.

Registration
Pre-registered participants may check-in at the event anytime before the race.
You may register for the event at the race, but may not receive a finisher medal.  
Check-in and Registration is from 8:15-9 am.
 
Course
Light cross country style 5k course along Gregory Creek to Pump Station Rd
The race is officially timed.

For more information please visit http://iredell-statesville.younglife.org/Pages/5k.aspx
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I am registering for: *
Participant / Donor Info
First Name *
Last Name *
Parent/Guardian Name
If participant is under 18
Gender *
Birthday *
Address *
City *
State *
Zip *
Phone Number *
Email *
Any necessary race communication will be sent here
How many additional medals would you like? *
Extra medals are available to all donors or participants for $5, please add $5 per medal to your payment/donation
Camper Sponsoring
If you're sponsoring a specific camper, please list their name here
Race Waiver
Please read the following waiver and indicate your response below: *
Acknowledgement of Inherent Risk, Waiver and Release:          1. I acknowledge and understand that there are inherent risks associated with participating in the Iredell County Young Life 5k (hereinafter “the Event”) that will be held for the benefit of Iredell County Young Life on May 13, 2017, including, but not limited to, those caused by terrain, facilities, temperature, weather, conditions of the athletes, equipment, vehicular traffic, actions of other people, including, but not limited to, participants, volunteers, spectators, coaches, event officials, and event monitors, and/or producers of the event, and lack of hydration. I will assume all of the risks associated therewith, whether known or unknown to me at this time. I acknowledge and certify that I am fit to run and/or walk in this event, have sufficiently trained for participation in this event and have not been advised otherwise by a qualified medical person. I hereby consent to medical treatment which may be deemed advisable in the event of injury, accident and/or illness during the Event.           2. In consideration of permitting me to participate in the Event, I release the following entities and/or persons and their directors, officers, employees, and agents from responsibility for my accidental physical injury, including death or illness, and loss of, or damage to, personal property while participating in this race: Young Life, The City of Statesville, and any other event holders, sponsors, directors and volunteers. This release is also intended to include all claims made by my family, estate, heirs, personal representative or assigns. I acknowledge and certify that I will indemnify and hold harmless the entities and/or persons mentioned in this paragraph from any and all liability and/or claims made by other individuals and/or entities as a result of my actions during the Event.          Acknowledgement of Inherent Risk, Waiver and Release for Minor Participant:          3. If I am under age 18, my parent or guardian, by signing below, also consents to my release and he or she agrees that this release shall be binding upon him or her as my parent or guardian as to me and my estate, heirs, personal representatives and assigns. My parent or guardian acknowledges that I am fit to participate in this event, as stated in paragraph 1. My parent or guardian also promises, by signing below, to defend, indemnify and hold Young Life, and the other entities and/or people named in paragraph 2, harmless from any claim asserted by me against Young Life and the other entities and/or people set forth in paragraph 2, including their trustees, employees and agents, if I should repudiate this release after obtaining adulthood.          Photo Release:          4. I hereby grant permission to Young Life the right to use, reproduce, and/or distribute photographs, films, videotapes, and sound recordings of me, without compensation or approval rights, for use in materials created for purposes of promoting the activities of Young Life.
Payment Details
Amount Enclosed *
$25 per runner, $5 per additional medal
I understand that I am not fully registered for the race until I pay online or by mailing a check to the office. *
IF PAYING ONLINE, you only need to fill out the required boxes on the first page.  If you are sponsoring a camper enter their name in the required camper name fields.  If you are not sponsoring a camper, please enter Not Applicable in the required name fields and be sure to hit SUBMIT on this form along with the payment as they are separate links.
Please contact Joey Gilleland with any questions or concerns at exitplan@roadrunner.com
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