{{ '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}}

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization.  COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact.  As a result, federal, state, and local governments and federal and state health agencies recommend physical distancing and have, in many locations, prohibited the congregation of groups and people.

            The Sertoma Club of Mesa (Club) has put in place preventative measures to reduce the spread of COVID-19; however, the Club cannot guarantee that you, your children, or any other person, will not become infected with COVID-19.  Further, attending Club sponsored activities could increase your risk and your child or children’s risk of contracting COVID-19. 

            By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child or children and I may be exposed to or infected by COVID-19 by attending Town activities and that such exposure or infection may result in personal injury, illness, permanent disability, and death.  I understand that the risk of becoming exposed to or infected by COVID-19 at Club activities may result from the actions, omissions, or negligence of myself and others, including but not limited to Club, City or other employees, volunteers, and program participants and their families. 

            I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child or children or myself, including, but not limited to, personal injury, disability, death, illness, damage, loss, claim, liability, or expense or any kind, that I or my child or children may experience or incur in connection with my child or children’s attendance at Club activities or programming.  On my behalf and on behalf of my child or children, I hereby release, covenant not to sue, discharge, and hold harmless and indemnify the Club, its employees, agents, and representatives, of and from any and all claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto.  I understand and agree that this release includes any claims based on the actions, omissions, or negligence of the Town, its employees, agents and representatives, whether a COVID-19 infection occurs before, during, or after participation in any Club program. 

 

 

In consideration of your acceptance of this entry, I hereby, for myself, my heirs, my executors and administrators, waive and release any and all rights and claims for damages I may have against the sponsors, Sertoma Club of Mesa, the City of Mesa, Raceplace Event Systems, USAT&F, coordinating groups, and any individuals associated with the event, their representatives, successors and assigns, and will hold them harmless for any and all injuries or illness suffered in connection with said event.  I certify that I am in good physical condition and capable of participating in this event.  Also, none of the above are responsible for the loss of personal items nor any other form of aggravation in connection with said event.  I have been warned I must be in good health to participate in this event.  In filling out this form, I acknowledge that I am an amateur in such events.  I also give permission for free use of my name and picture in any broadcast, telecast or print media account of this event.  In filling out this form, I acknowledge I have read and fully understand my own liability and do accept the restrictions.  This entry is invalid unless signed by participant.  If entrant is under  18 years of age, parent or legal guardian must sign below.

{{ 'MUST-AGREE' | translate}}

{{ 'MUST-AGREE' | translate}}

All participants will receive a unique, high quality super soft shirt.

{{ !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 }}

{{ '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