Jag Force 5K Registration

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Submit online form. Then you may bring your $25 entry fee (cash or check only) to the race October 29, 2022, or you may send your payment by check to :

Scottsburg High School Jag

c/o Bobby Ashley - Jag Coordinator

500 S. Gardner Street

Scottsburg, IN 47170

Email *

ALL PROCEEDS WILL BE DONATED TO ST. JUDE'S CHILDREN'S HOSPITAL.

Shirt Size - These will be standard men's cut shirts. *

Adult S

Adult M

Adult L

Adult XL

Adult. XXL

Adult 3XL

Adult 4XL

Child S

Child M

Child L

Child XL

Last Name *

First Name *

Email Address *

Home Address *

Phone Number *

Birthday *

YYYY

Select ALL that apply. *

Male

Female

Adult

Child

EVENT DISCLAIMER: Please review the following waiver and disclaimer. By typing your name in this box, you agree to the following:

I ACKNOWLEDGE THAT MY PARTICIPATION IN THE JAG FORCE 5K RACE MAY INVOLVE A RISK OF INJURY,INCLUDING BODILY INJURY, AND ASSUME THE RISK FOR SAME. ON MY OWN BEHALF AND ON BEHALF OF MY HEIRS AND LEGAL REPRESENTATIVES AND TO THE FULLEST EXTENT PERMITTED BY LAW, I HEREBY RELEASE AND DISCHARGE ANY AND ALL LIABILITY FOR INJURY, DEATH, OR DAMAGES AND/OR ANY OTHER CLAIMS, DEMANDS, LOSSES, OR DAMAGES, INCURRED BY ME IN CONNECTION WITH ANY ASPECT OF THE 5K RACE.

Send me a copy of my responses.

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