14th Annual Run/Walk/Skate for Suicide Prevention
Location:
Anywhere you choose!
Date/Time:
Anytime between August 1st - September 12, 2020
Number of People I am registering. (Do not choose this if you are trying to beat your time.)
*
0
1
2
3
4
5
6
7
8
9
10
I would like to make a donation
Enter Amount You'd Like To Donate
I am running again to BEAT my time!
I registered once, now I'm going to try it again!
Amount Due
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USD
You will complete payment once you hit the submit button.
Amount Due:
You will complete payment once you hit the submit button.
Participant Details
(Size 2X T-shirt is out of stock)
Name
*
First Name
Last Name
Age
*
Date of Birth
*
-
Month
-
Day
Year
Date
Sex
*
Female
Male
Email
*
example@example.com
Phone Number (to be used for prize notification only)
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Event Type:
*
5K/10K Run (will submit running time for competition)
Walk or Skate (not timed)
Picture / Avatar
Browse Files
Cancel
of
I am part of a team:
Yes
No
Team Name
T-Shirt Size
*
Small
Medium
Large
X-Large
3X
No thanks
Choose one
I want a running bib as a souvenir
*
Yes please!
No thanks
Team Members I'm Registering
Name-2
*
First Name
Last Name
Age
*
Sex
*
Female
Male
Event Type:
*
5K/10K Run (will submit running time for competition)
Walk or Skate (not timed)
City
*
Picture / Avatar
Browse Files
Cancel
of
T-Shirt Size
*
Small
Medium
Large
X-Large
3X
No thanks
Choose one
I want a running bib as a souvenir
*
Yes please!
No thanks
Name-3
*
First Name
Last Name
Age
*
Sex
*
Female
Male
Event Type:
*
5K/10K Run (will submit running time for competition)
Walk or Skate (not timed)
City
*
Picture / Avatar
Browse Files
Cancel
of
T-Shirt Size
*
Small
Medium
Large
X-Large
3X
No thanks
Choose one
I want a running bib as a souvenir
*
Yes please!
No thanks
Name-4
*
First Name
Last Name
Age
*
Sex
*
Female
Male
Event Type:
*
5K/10K Run (will submit running time for competition)
Walk or Skate (not timed)
City
*
Picture / Avatar
Browse Files
Cancel
of
T-Shirt Size
*
Small
Medium
Large
X-Large
3X
No thanks
Choose one
I want a running bib as a souvenir
*
Yes please!
No thanks
Name-5
*
First Name
Last Name
Age
*
Sex
*
Female
Male
Event Type:
*
5K/10K Run (will submit running time for competition)
Walk or Skate (not timed)
City
*
Picture / Avatar
Browse Files
Cancel
of
T-Shirt Size
*
Small
Medium
Large
X-Large
3X
No thanks
Choose one
I want a running bib as a souvenir
*
Yes please!
No thanks
Name-6
*
First Name
Last Name
Age
*
Sex
*
Female
Male
Event Type:
*
5K/10K Run (will submit running time for competition)
Walk or Skate (not timed)
City
*
Picture / Avatar
Browse Files
Cancel
of
T-Shirt Size
*
Small
Medium
Large
X-Large
3X
No thanks
Choose one
I want a running bib as a souvenir
*
Yes please!
No thanks
Name-7
*
First Name
Last Name
Age
*
Sex
*
Female
Male
Event Type:
*
5K/10K Run (will submit running time for competition)
Walk or Skate (not timed)
City
*
Picture / Avatar
Browse Files
Cancel
of
T-Shirt Size
*
Small
Medium
Large
X-Large
3X
No thanks
Choose one
I want a running bib as a souvenir
*
Yes please!
No thanks
Name-8
*
First Name
Last Name
Age
*
Sex
*
Female
Male
Event Type:
*
5K/10K Run (will submit running time for competition)
Walk or Skate (not timed)
City
*
Picture / Avatar
Browse Files
Cancel
of
T-Shirt Size
*
Small
Medium
Large
X-Large
3X
No thanks
Choose one
I want a running bib as a souvenir
*
Yes please!
No thanks
Name-9
*
First Name
Last Name
Age
*
Sex
*
Female
Male
Event Type:
*
5K/10K Run (will submit running time for competition)
Walk or Skate (not timed)
City
*
Picture / Avatar
Browse Files
Cancel
of
T-Shirt Size
*
Small
Medium
Large
X-Large
3X
No thanks
Choose one
I want a running bib as a souvenir
*
Yes please!
No thanks
Name-10
*
First Name
Last Name
Age
*
Sex
*
Female
Male
Event Type:
*
5K/10K Run (will submit running time for competition)
Walk or Skate (not timed)
City
*
Picture / Avatar
Browse Files
Cancel
of
T-Shirt Size
*
Small
Medium
Large
X-Large
3X
No thanks
Choose one
I want a running bib as a souvenir
*
Yes please!
No thanks
Waiver & Release
*
The Virtual Race is being held on the honor system. (If choosing to compete), I will uphold the spirit of honest racing by running the full distance of my race and reporting accurate times with a picture of my running app or a map and time of my run.
I release Evergreen Youth & Family Services for any responsibility in case of an accident, illness, or injury.
I allow my photo to be taken during the event and used for event advertising and marketing.
Participant's Signature
Date Signed
-
Month
-
Day
Year
Date
Parent/Guardian Signature (If participant is below 18 years old)
Payment
You will be taken to a payment page after clicking the "Submit" button below.
Submit
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