5K Registration16 AND UP REGISTRATIONPlease register for our 3rd Annual 5K Survivor’s Run below. See you on October 5, 2019 at Legacy Loop Plaza! 15 and Under can register here REGISTER HERE Individual RunnersNO Runner- Team InsteadOne RunnerTwo RunnersThree RunnersFour Runners6 Runners7 Runners8 Runners9 Runners11 Runners12 Runners13 Runners14 RunnersTeam PurchaseTeam of 5Team of 10Team of 15Team of 20Discount Price: -$25.00 Please list the name of the participant:* First Last Please list the name of the 2nd participant: First Last Please list the name of the 3rd participant: First Last Please list the name of the 4th participant: First Last Please list the name of the 5th participant: First Last Other Participants NamesIf you have more than 5 participants, please list there names below with Shirt Sizes next to themWhat size T-shirt would you like?*Adult SAdult MAdult LAdult XLWhat size T-shirt would 2nd participant like?Adult SAdult MAdult LAdult XLChild SChild MChild LChild XLWhat size T-shirt would 3rd participant like?Adult SAdult MAdult LAdult XLChild SChild MChild LChild XLWhat size T-shirt would 4th participant like?Adult SAdult MAdult LAdult XLChild SChild MChild LChild XLWhat size T-shirt would 5th participant like?Adult SAdult MAdult LAdult XLChild SChild MChild LChild XLWhat is Your Team Name?Email* Phone*Credit Card* Card Details Cardholder Name Billing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Liability Waiver Agreement*I know that running/walking is a potentially hazardous activity. I should not enter or run or walk in this event unless I am medically able & properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I assume all risks associated with running in this race including, but not limited to, falls, contact with other participants, the effects of weather, including high heat and/or humidity or snow/ice, the conditions of the road and traffic on the course, all such risks being known and appreciated by me. Having read this waiver and knowing these facts, and in consideration of your acceptance of my application, I, for myself, and anyone entitled to act on my behalf, waive and release TESSA, their employees staff and volunteers, LYMEvents LLC the race organizers and volunteers, all sponsors, the City of Colorado Springs and their managers, members, owners employees, agents and their representatives and successors, and all volunteers 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. I certify that I am physically able to participate in this event. I understand that all fees are non-refundable, and I also allow my name and image to be posted in the results in various media such as newspaper, periodicals and the web. I agree to the above liability waiver.Promo Codeplease enter promo code hereTotal $0.00 EmailThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.