{{ 'SHOW_CART' | translate }} >

{{total | currency:"$"}}

{{::eventInfo.eventName}}

{{eventInfo.startDateUnix | localeLongDate:currentLanguage : 'LLL' : eventInfo.eventTimeZone : true}}
{{::eventInfo.where}}

{{::eventInfo.description}}

{{ 'COUPON-APPLIED' | translate }}

{{ 'INVALID-SECONDARY-COUPON' | translate }}

{{ 'PLEASE-PROVIDE-VALUE' | translate}}

{{ 'FIRST-NAME' | translate}}

{{ 'REQUIRED' | translate }}

No emails or URLs allowed

{{ 'IDENT.NAME_CHARS_LONG' | translate}}

{{ 'LAST-NAME' | translate}}

{{ 'REQUIRED' | translate }}

No emails or URLs allowed

{{ 'IDENT.NAME_CHARS_LONG' | translate}}

{{ 'BIRTH-DATE' | translate}}

{{ 'IDENT.RACE_AGE_BETWEEN' | translate:regOptionAgeTranslate }}

{{ 'IDENT.SERIES_RACE_AGE_ERROR' | translate }}

{{ 'REQUIRED' | translate }}

{{'REQUIRED_DATE_FORMAT' | translate:'{format: eventInfo.displayDateFormat}' }}

{{ 'GENDER' | translate}}

{{ 'REG-OPTION-GENDER-ERROR' | translate}}

{{ 'PRIMARY-PHONE' | translate}}

{{ 'PROVIDE-VALUE' | translate}}

{{ 'NOT-VALID-PHONE-NUMBER' | translate}}

{{ 'EMAIL' | translate}}

{{ 'EMAIL-CONFIRM' | translate}}

{{ 'PROVIDE-VALUE' | translate}}

{{ 'ENTER_VALID_EMAIL' | translate }}

{{ 'SAME-EMAIL' | translate}}

{{ 'PARTICIPANT-CONDITION' | translate}}

{{ 'ADDRESS' | translate }}

{{ 'COUNTRY' | translate}}

{{ 'PLEASE-PROVIDE-VALUE' | translate}}

{{ 'STREET' | translate}}

{{ 'PLEASE-PROVIDE-VALUE' | translate}}

{{ 'STREET_2' | translate}}

{{ 'POSTAL-CODE' | translate}}

{{ 'PLEASE-PROVIDE-VALUE' | translate}} {{ 'VALID-ZIP' | translate}}

{{ 'CITY' | translate}}

{{ 'PLEASE-PROVIDE-VALUE' | translate}}

{{ 'STATE/REGION' | translate}}

{{ 'PLEASE-PROVIDE-VALUE' | translate}}

{{ 'EMERGENCY-CONTACT' | translate }}

{{ 'EMERGENCY-CONTACT' | translate}}

{{ 'REQUIRED' | translate }}

{{ 'RELATIONSHIP' | translate}}

{{ 'PHONE' | translate}}

{{ 'PROVIDE-VALUE' | translate}}

{{ 'NOT-VALID-PHONE-NUMBER' | translate}}

{{ 'CONTACT-CANNOT-BE-EVENT-P' | translate}}

{{ 'DATA-PRIVACY' | translate}}

{{ 'EMAILS-REGARDING-REG-NO-PARAM' | translate}}

{{ eventInfo.marketingConsentQuestionText}}

{{eventInfo.marketingEmailQuestionText}}

In consideration of allowing me, the undersigned, to participate in one or more of the Events described above ("Event") I, for myself, and on behalf of my spouse, children, guardians, heirs and next of kin and any legal and personal representatives, executors, administrators, successors and assigns, hereby agree to make the following contractual representations pursuant to this Waiver and Release of Liability Agreement ("Agreement").
  1. I represent (i) I am at least eighteen (18) years of age or older; (ii) I am in good health and in proper physical condition to participate in the Event; and (iii) I am not nor will I be under the influence of alcohol or any illicit or prescription drugs which would in any way impair my ability to safely participate in the Event. I agree it is my sole responsibility to determine whether I am sufficiently fit and healthy enough to participate in the Event. I am responsible for my own safety and well being at all times and under all circumstances before, during and after the Event.
  2. I understand participating in road racing is inherently dangerous and represents an extreme test of person’s physical and mental limits. I understand and appreciate the risks and dangers associated with participation in the Event and related activities, including without limitation, the potential for serious bodily injury, sickness, disease, permanent disability, paralysis and loss of life; loss of or damage to equipment/property; exposure to extreme conditions and circumstances; contact with other participants, spectators, animals or other natural or manmade objects; dangers arising from adverse weather conditions such as heat and humidity; imperfect course conditions; land, water and surface hazards; equipment failure; inadequate safety measures; participants of varying skill levels; situations beyond the immediate control of the Event Organizer; and other undefined, not readily foreseeable and presently unknown risk and dangers ("Risks"). I understand these Risks may be caused, in whole or in part, by my own actions or inactions, the actions or inactions of others participating in the Event, or the negligent acts or omissions of the Released Parties defined herein, and I hereby expressly assume all such Risks and responsibility for any damages, liabilities, losses or expenses which I incur as a result of my participation in the Event.
  3. I hereby release, waive and hold harmless the following parties: Bix7, Super Race Systems, Quad-City Times, Cornbelt Running Club, its directors, officers, members and volunteers; the City of Davenport; the Event directors and committees; organizers and promoters; sponsors, advertisers, the facility, venue and property owners or operators upon which the Event including the post event party takes place; law enforcement agencies, healthcare providers or other public entities providing support for the Event; and each of their respective parent, subsidiary, and affiliated companies, officers, directors, partners, shareholders, members, agents, employees and volunteers (individually and collectively the "Released Parties" or "Event Organizers"), with respect to any liability, claims, demands, cause of action, damages, loss or expense (including courts costs and reasonable attorney’s fees) of any kind or nature ("Liability") which may arise out of, result from, or relate in any way to my participation in the Event including claims for Liability caused, in whole or in part, by the negligent acts or omissions of the Released Parties.
I hereby warrant that I am of legal age and competent to enter into this Agreement. I have read this Agreement carefully understanding its terms. I acknowledge I am giving up substantial legal rights by signing it (including the rights of my spouse, children, guardians, heirs and next of kin, and any legal and personal representatives, executors, administrators, successors and assigns), acknowledge I have signed this Agreement without any inducement, assurance or guarantee, and intend for my signature to serve as confirmation of my complete and unconditional acceptance of the terms, conditions and provisions of this Agreement. This Agreement represents the complete understanding between the parties regarding these issues and no oral representations, statements or inducements have been made apart from this Agreement. If any provision of this Agreement is held to be unlawful, void, or for any reason unenforceable, then that provision shall be deemed severable from this Agreement and shall not affect the validity and enforceability of any remaining provisions.

{{ 'MUST-AGREE' | translate}}

Friday, Saturday, Sunday souvenir results editions of the Quad-City Times mailed anywhere in the U.S. at $10.00 each.

{{ 'REQUIRED' | translate }}

This is not valid integer. Value needs to be between '1' and '10' Value needs to be between '1' and '10'

{{ 'REQUIRED' | translate }}

ONLY type below for Bix Packages not shipping to your home.
{{'VALUE_SHORTER_THAN' | translate:'{char: "1000"}' }}

{{ 'REQUIRED' | translate }}

Home or No for mailing

{{ 'REQUIRED' | translate }}

{{ !gigyaLoaded() ? 'GET-ATHLETE-UPDATE-MOBILE' : 'GET-ATHLETE-UPDATE' | translate}}

{{ !gigyaLoaded() ? 'MOBILE-DELIVER' : 'FACEBOOK-DELIVER' | translate}}

{{ 'COUPON-APPLIED' | translate }}

{{ 'INVALID-COUPON' | translate }}

{{ 'PLEASE-PROVIDE-VALUE' | translate}}

{{ 'ITEM-FREE' | translate }} * {{ 'MAKE-SELECTION' | translate }}
  • {{ 'VIEW-IMAGES' | translate }}

{{ entry.storefront.products[product.id].price | currency:"": currency.decimal }}

{{ 'FREE' | translate }}

{{ product.name }}

{{ product.description }}

* {{ 'SHIPMENT-ONLY' | translate }}

* {{ 'EVENT-PICKUP-ONLY' | translate }}

SKU# {{product.sku}}
{{ 'ONLY' | translate }} ({{getProductOptionRemainingQty(option, product.id, entries, true)}}) {{ 'IN-STOCK' | translate }}
{{ 'ITEM-FREE' | translate }} * {{ 'MAKE-SELECTION' | translate }}
  • {{ 'VIEW-IMAGES' | translate }}

{{ entry.storefront.products[product.id].price | currency:"": currency.decimal }}

{{ 'FREE' | translate }}

{{ product.name }}

{{ product.description }}

* {{ 'SHIPMENT-ONLY' | translate }}

* {{ 'EVENT-PICKUP-ONLY' | translate }}

SKU# {{product.sku}}
{{ 'ONLY' | translate }} ({{getProductOptionRemainingQty(option, product.id, entries, true)}}) {{ 'IN-STOCK' | translate }}

Honoring Our Local Veterans


{{ 'PAYMENT-ERROR' | translate}}

{{paymentErrors.message}}

  • {{error}}
  • {{errValue}}

{{ 'CORRECT_ERRORS_FOR_ENTRY' | translate }}

{{ 'COMPLETE_REGISTRATION_FOR_ENTRIES' | translate}}

{{entry.name | translateIf:entry.translate}}

{{ 'EDIT' | translate }} (errors)

{{item.name | translateIf:item.translate}} :

{{item.price | currency:"$":currency.decimal}}
Remove
{{ 'SUBTOTAL' | translate}} : {{cart.subtotal | currency:"$":currency.decimal}}
{{customFee.description}} : {{customFee.price | currency:"$":currency.decimal}}
{{ 'PROCESSING_FEE' | translate }} : {{cart.fee | currency:"$":currency.decimal}}
{{ 'SALES_FEE' | translate}} : {{cart.totalSales | currency:"$":currency.decimal}}
{{!cart.hasLottery ? ('TOTAL'|translate) : ('TOTAL_CHARGE_AT_CHECKOUT'|translate)}} : {{cart.total | currency:"$": currency.decimal}}

{{item.name | translateIf:item.translate}} :

{{item.price | currency:"$":currency.decimal}}
Remove
{{ 'SUBTOTAL' | translate}} : {{cart.subtotalLottery | currency:"$": currency.decimal}}
{{customFee.description}} : {{customFee.price | currency:"$": currency.decimal}}
{{ 'PROCESSING_FEE' | translate }} : {{cart.lotteryFee | currency:"$":currency.decimal}}
{{ 'TOTAL_CHARGE_IF_SELECTED' | translate}} : {{cart.lotteryTotal | currency:"$": currency.decimal}}
{{ 'IF_SELECTED_CHECKOUT' | translate:cart}}

{{ 'PAYMENT-ERROR' | translate}}

{{paymentErrors.message}}

  • {{error}}
  • {{errValue}}
{{ 'NO-PAYMENT-REQUIRED' | translate }}
{{ 'MASTERPASS-TAGLINE' | translate }}

{{ 'MASTERPASS-HEADLINE' | translate }}

{{ 'MASTERPASS-DESCRIPTION' | translate }}


{{ 'OR' | translate }}

{{ 'NAME-ON-CARD' | translate }}

{{ 'REQUIRED' | translate }} {{ 'PAYMENT-NAME-MIN-LENGTH' | translate }}

{{ 'CARD-NUMBER' | translate }}
{{ 'EXPIRATION' | translate }}
{{ 'SECURITY-CODE' | translate }}
{{ 'POSTAL-CODE' | translate }}
{{ 'CARD-NUMBER' | translate }}
{{ 'EXPIRATION' | translate }}
{{ 'SECURITY-CODE' | translate }}
{{ 'POSTAL-CODE' | translate }}

{{ 'REQUIRED' | translate }}

{{'SHIPPING-ADDRESS' | translate}}


{{ 'FIRST-NAME' | translate }}

{{ 'REQUIRED' | translate }}

{{ 'ENTER_VALID_EMAIL' | translate }}

{{ 'LAST-NAME' | translate }}

{{ 'REQUIRED' | translate }}

{{ 'ENTER_VALID_EMAIL' | translate }}

{{ 'COUNTRY' | translate }}

{{ 'REQUIRED' | translate }}

{{ 'POSTAL-CODE' | translate }}

{{ 'REQUIRED' | translate }}

{{ 'ENTER_VALID_EMAIL' | translate }}

{{ 'STREET' | translate }}

{{ 'REQUIRED' | translate }}

{{ 'ENTER_VALID_EMAIL' | translate }}

{{ 'CITY' | translate }}

{{ 'REQUIRED' | translate }}

{{ 'ENTER_VALID_EMAIL' | translate }}

{{ 'EMAIL' | translate }}

{{ 'REQUIRED' | translate }}

{{ 'ENTER_VALID_EMAIL' | translate }}

{{ 'REGION' | translate }}

{{ 'REQUIRED' | translate }}


{{ 'PAYMENT-INFORMATION' | translate }}


{{ 'NAME-ON-CARD' | translate }}

{{ 'REQUIRED' | translate }} {{ 'PAYMENT-NAME-MIN-LENGTH' | translate }}

{{ 'CARD-NUMBER' | translate }}

{{ 'REQUIRED' | translate }} {{ 'INVALID-CREDIT-CARD-NUMBER' | translate }}

{{ 'EXPIRATION' | translate }}

{{ 'REQUIRED' | translate }} {{ 'INVALID-EXPIRATION-DATE' | translate }}

{{ 'SECURITY-CODE' | translate }} (CSC/CVC/CVV)

{{ 'REQUIRED' | translate }} {{ 'INVALID-SECURITY-CODE' | translate }}

{{ 'REQUIRED' | translate }}

{{ 'PAYMENT-INFORMATION-MESSAGE' | translate }}


Get your friends to join you
Have {{entryReferralData.goal}} friends sign up using the link below to receive {{entryReferralData.award | currency:"$"}}
Share to Facebook Copy Referral Link

{{crowdriseTeam.entryName}} Charity Event Fundraising on Crowdrise

{{crowdriseTeam.entryName}}: {{crowdriseTeam.msg}} (Crowdrise error)

The internet browser you are using to access this registration form is not supported. Please upgrade your browser or register on your mobile device.
Scan this QR Code with your mobile device to load the mobile registration form.
Event registration link