Participant Registration

The price for the 5K Run is $15.00 and the 1 Mile Walk is $10.00 per person. Please indicate which event you would like to participate in below and mail your payment to the address listed below.

Alternatively you may click the link below to print out a participant registration form and mail it as well as payment to the address mentioned below.

Print out and mail in form by clicking here.

Amy’s Race
c/o Lisa McInerney
47023 322nd Street
Elk Point, SD 57025

In consideration of the acceptance of my entry, I for myself, my executors and assignees, do release and discharge the sponsors and coordinators of Amy’s Race from all claims of damages, actions and causes of actions, whatsoever, in any manner arising or growing out of my participation in said athletic event. I hereby attest that I am physically fit and able to participate in Amy’s Race 5K run or 1 Mile Walk.

Last Name *

First Name

Age *

Address *

Phone

Email Address

Event *

Shirt Size

Amys Race

"Race For A Cure"