2010 Fall Fest in the Park

5 K Run and Walk

Registration Form

Parowan City Fall Fest in the park welcomes a 5K Run and Walk sponsored by the Parowan Chamber of Commerce. It will be held Saturday, October 9, 2010 in the Parowan Park located at Main and Center. The Run will start at 10:00 a.m. at the Old Rock Church and will finish at the same place. For more information call 435-477-9022 or 435-559-4504

To Pre-register, complete the following information and then mail your registration fee to: Parowan City Events, P.O. Box 1165, Parowan Utah 84761 or bring to the Parowan Visitors Center, 73 N Main, Parowan Utah.

First Name * Your First Name

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Last Name * Your Last Name

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Mailing Address * Your Post Office Box or Street Address for Mailing

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City * Your City

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State * State of Residence

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Zip Code Mailing Zip Code

Email Address * Email Address it will only be used for 5K information

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Phone Number * Your best phone number

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Date of Birth * Birthday

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Shirt Size *

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Pre-registration fee, make checks payable to Parowan Chamber of Commerce

Registration Type *

10.00 pre registration received by Sep. 24, 2010
15.00 Fee Paid Day of Race
High School Team Member

Please select a Registration Type

Type of Race * Walk Run Will you compete as a runner or as a walker

Please complete your race type

Age Group *

Please select an age group

Gender * Male Female Male or Female

Please select a gender

Emergency Contact * Person to contact in case of Emergency

Please enter an Emergency Contact

Emergency Phone * Best Phone Number for Emergency Contact

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I understand that a 5K run is a strenuous event and that I should consult my Physician prior to participating in such an event. I am entering this event voluntarily and will not hold Parowan City or Parowan Chamber of Commerce or any other employee or volunteers responsible for any injury I may experience as a result of my participation in the event.

To Be Signed at Check-In____________________________________________________ Date__10/09/2010

Signature of Participant

To Be Signed at Check-In____________________________________________________ Date__10/09/2010

Signature of Guardian

Digital Consent to above(MUST BE CHECKED TO CONTINUE) * Sign this form with a digital signature

You must accept the statements on this form to register

By checking the digital concent box above you accept the statement in the paragraph preceding and agree to it completely and without restriction.

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Parowan Utah

Elevation 5960 ft
Population 2800

Main Menu

2010 Fall Fest in the Park

5 K Run and Walk

Registration Form

Copyright 2010 Parowan City Corporation
Webdesign by Jerry Bixman

Parowan Utah

Elevation 5960 ft Population 2800

Main Menu

2010 Fall Fest in the Park

5 K Run and Walk

Registration Form

Copyright 2010 Parowan City Corporation Webdesign by Jerry Bixman

Elevation 5960 ft
Population 2800

Copyright 2010 Parowan City Corporation
Webdesign by Jerry Bixman