On-site / Reg - ChronoTrack

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First Name

Last Name

Birth Date

MM/DD/YYYY

Gender

Female Male Non Binary

Country

Postal Code

Email

Phone Number

We ask for email so we can communicate with you about this registration.

Waiver: By submitting this form, I assume full and complete responsibility for any injury or accident which may occur to me during the event or while I am on the premises of the event. Having read this waiver, and knowing these facts and in consideration of your accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release Best Maid Pickles, Fort Worth Running Company and the City of Fort Worth and all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. Further, I grant permission to use any photographs, videotapes, or any other records of this event involving me for any legitimate purpose. Race will be held regardless of weather conditions unless otherwise notified on race day. Registration is final and non-refundable. Parent or guardian must sign waiver if participant is under 18yrs old.

Parent/Guardian Initials

Donation

$5 $10 $20 $50

$100 No Thanks Other Donation Amount

The Smiley Fund was founded in 2013 to provide at-risk American Children with the means to achieve success and live healthy lifestyles. We strive to change the lives of at-risk and impoverished children in the Dallas-Fort Worth Metroplex. Through donations to the Smiley Fund, we can provide after-school programs for children in need of mentoring and tutoring to better their chances for getting into a four-year college. In addition to donating to after-school programming, the Smiley Fund offers a partial college scholarship to many students each year that have participated in the Smiley Fund's designated after-school programming.

Payment Type

Checkout - Credit Cash/Check Register Another

Name on Card

When you click 'Pay' your credit card will be charged .

Please pay attendant $ xxx

Bib

Please pay attendant $ xxx

Name
Hometown	,
Gender
Age
Race

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Have a great race!