The National Graduates 5K Walkathon: Promoting Adult Literacy/Basic Education to Bridge the Achievement Gap
All participants must complete the registration form to participate in the 5K walkathon.  To learn more about the event, please visit our website.  Please contact YOURpath4adultlearners@gmail.com if you have any problems submitting this form.  Thank you!
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Email *
Full Name (First & Last) *
Full Address (including city, state and zip code) *
Telephone Number *
Education Achievement Level *
Age Range *
Race/Ethnicity *
Income Level *
Your driving distance to the Event: *
Physical Fitness Health Level (Self-Assessment) *
Emergency Contact Person.  Please provide the full name, address (include city, state, & zip code), and phone number to contact in case of an emergency.   *
Liability Waiver: All participants agree to participate in this 5K walkathon event for Adult Literacy and Basic Education at their own risk, and will not hold the organization, sponsors, Board Directors/Members, associates, vendors liable for any injuries or accidents that my occur as a result of participating in this event.   *
Photo Consents: I understand and agree that the organization will be taking photos and video recording during the event to post on its website, in newsletter and other social media platforms.  Photos and recordings will only be used by the organization, YOURpath for Adult Learners, and will NOT be sold to any other organizations for use or misuse.   *
No Refund Policy: I understand that my registration/donation is final.  There will NOT be any refunds of purchase.  I understand that if the event is cancelled due to inclement weather or some other relevant cause, the organization, YOURpath for Adult Learners, will contact me with further instructions at least a week to 24 hours before the event.   *
Safety Requirements: I understand that I must wear and mask to attend the event.  It is also recommended that I bring hand sanitizer.  2) I understand that I should avoid wearing handbags or any valuable possessions.   *
Health Safety: I understand that it is highly recommended that I consult with my primary physician before participating in this event.   *
Event Registration donation: *
I am interested in sponsoring a person or persons to attend the event.   *
OPTIONAL: Please purchase your Logo T-Shirt here: https://teespring.com/supporter-of-adult-education?pid=2 before completing your check out.  
OPTIONAL: You don't have your cap and gown; no worries!  Please visit Amazon to purchase a cap and gown: https://www.amazon.com/s?k=cap+and+gown&crid=21H5C2MRHCCEF&sprefix=cap+and+gow%2Caps%2C405&ref=nb_sb_noss_2

Your purchase receipt serves as your entry pass into the event.  Please bring your receipt with you to the event.   *
Electronic Signature: Please sign below.  I understand and agree that my signature below will serve as my authorized signature, having the same legal weight as my handwritten signature in the court of law.  I sign freely and under no duress. *
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