Amanda's Memorial Event Registration
Event Timing: Saturday, October 25th
     7:00 am Registration Begins
     8:00 am Race Begins
Event Address: Bridge View Center
102 Church St, Ottumwa, IA 52501
Contact us at (319) 458-0072 or eventsbyemelia@yahoo.com
Sign in to Google to save your progress. Learn more
How Your Support Makes a Difference

Funds raised from Amanda’s Memorial Run will go toward supporting a Davis County High School student — an outstanding cross country or track athlete who embodies the dedication and spirit Amanda showed every day.

Amanda left a lasting legacy on both her cross country and track teams during her time at DCHS, and we’re proud to continue honoring her by giving back to the place and sport that meant so much to her.

Thank you for helping us keep her memory alive in such a meaningful way.

First and Last Name *
Email *
Date of Birth *
MM
/
DD
/
YYYY
Race Option *
Required
T-Shirt Size (unisex)
Clear selection
Emergency Contact (Name, Relationship, Phone Number) *

Waiver and Release of Liability

I understand that participating in a running or walking event involves inherent physical risks. By signing below, I voluntarily assume all risks associated with my participation in this event. I hereby release and hold harmless the event organizers, sponsors, volunteers, and affiliated parties from any and all liability, claims, or causes of action arising from injury, illness, or damages that may occur as a result of my participation.

I certify that I am physically capable of safely participating in this event and agree to follow all event rules, guidelines, and safety instructions.

Participant Name (as signature):

*
Payment Information *
I give permission for my photo to be used in event promotions *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report