Suicide Prevention 5k and Color Run Registration
Event Timing: March 16th, 2019
9:00 AM - 3:00 PM
Event Address: Nelson County High School, Lovingston, VA
Track and Field

Family , Career, and Community Leaders of America (FCCLA) is partnering with Stamp Out Stigma to host this Suicide Prevention Event. We are doing this event to raise awareness, remember the ones taken, and to show the importance of this world wide problem. Money from the races and other donations will go to the American Foundation of Suicide Prevention.

Name *
Your answer
Gender *
Required
Age Range *
Email *
Your answer
Phone Number *
Your answer
Emergency Contact *
Your answer
Select which race(s) you want to participate in *
T-Shirt Size *
Waiver and Release:
I understand that running is a potentially hazardous activity. I should not enter unless I am medically able. I assume all risks associated with running in this event, including but not limited to falls, contact with other runners, the effects of weather,traffic conditions of the course, all such risks being known and appreciated by me. Having read this waiver and knowing these facts, and in consideration of my entry, I for myself and anyone entitled to act on my behalf, waive and release Nelson County High School, and all of their liabilities of any kind arising out of my participation in this event even though liability may arise out of negligence or carelessness arising on the part of the persons named in this waiver.
Do you understand and agree?
Instructions on how to submit an online payment:
You will be using MySchoolBucks to make this transaction. When you copy and paste the link into a new browser, you'll either need to log in or create a new free account. Once you have logged in, click on "School Store" on the top right of the screen, then scroll down to "Featured Items." To register for one race, click on the left link. To register for both races, click on the right link.
To pay for the race(s), you must use this link to pay with credit or debit (can pay with cash or check day of event): https://www.myschoolbucks.com/ver2/login/getmain.action *
Submit
Never submit passwords through Google Forms.
This form was created inside of Nelson County Public Schools. Report Abuse - Terms of Service