Healing H'Arts Equestrian Center

REGISTRATION FORM

9^th year of Sap Run/Walk/Roll 5k  

SATURDAY MAY 2, 2026

Name: ____________________________________

Address: ___________________________________

City: ___________________ State: ___   Zip: _______

Age as of May 2, 2026: _______________________

Circle Shirt Size: Youth: S M L   ADULT: S M L XL XXL   No shirt: ___

Please Make Checks Payable: Healing H’Arts

Return To: Kirsta Malone

Release of Liability

I realize that running/walking can be a hazardous activity.  I and my heirs, executors, administrators and assigns do hereby release the organizers, sponsors, race personnel and all members of the Healing H’Arts Equestrian Center, Inc. from responsibility from any damages suffered by me as a result of my participation in this run/walk.  I give my permission for any photos to be taken to be used for promotional purposes.  I attest that I am healthy and fit enough to safely participate on the day of the run/walk. I will take full responsibility for my own safety before, during and after the event.

Signature: _______________________________________

Date: _______________________

Guardian Signature (if under 18): _________________________________________________

Emergency Contact Person: ______________________

Relationship to you: ____________

Emergency Contact Phone Number: _______________________________________________