2022 Georgia AHPERD Convention 5K Registration

USE THIS FORM TO REGISTER AND PAY ONLINE!

The 2022 Georgia AHPERD Convention 5K will be held on a date of your choice between November 13-15, 2022. Participants do not have to attend the Convention in Athens to run the event. However, Convention attendees are welcome to run their 5K during the event in Athens! 5K registration fees include a long sleeve race T-shirt and delivery (at Convention or mailed home). Fitbit has graciously donated prizes to be awarded to participants in the event!

For additional information on the Georgia AHPERD Convention 5K, contact Kim Thompson at kthompson.gahperd@att.net or 770-852-1543.

First Name *

Last Name *

Mailing Address *

Address Line 2

City *

State *

Zip Code *

Country *

Cell Phone Number *

Email Address *

School District of Employment *

School *

Age as of November 13, 2022 *

Gender *

Male

Female

How will you be completing your 5K? *

Walk

Run

Other (Insert choice below) Other (Insert choice below)

EVENT WAIVER - I know that running in an event that is organized as a virtual activity where I run on my own, at a date and time of my choosing, in a location and running route of my choosing, which will not have any support or security measures in place by GAHPERD Inc. is a potentially hazardous activity, which could result in injury or death. I acknowledge that I am participating in the activity outlined by this virtual event by my own free will and at my own personal risk. I will not participate in a virtual event unless I am medically able and properly trained, and by my signature, I certify that I am medically able to perform this event, and am in good health, and I am properly trained. I further agree to abide by the Center for Disease Control’s (CDC) recommendations for the prevention of the spread of the 2019 Novel Coronavirus Disease (COVID-19) and other communicable diseases, and I attest to having read the CDC’s guidance at: https://www.cdc.gov/coronavirus/2019-ncov/prepare/prevention.html. I attest that if my community has a shelter in place order, that I will only participate in the virtual event by using a personal treadmill, and I will not run outside in the community during the duration of a shelter in place order. I agree to follow all pedestrian safety ordinances including running on a sidewalk where available and not in the road. I agree to follow the rules of the road if no sidewalk or multi-use trail is available, and I will run against oncoming traffic and not with traffic. I agree to abide by any decision of a race official relative to any aspect of my participation in this virtual event, including the right of any official to deny or suspend my participation for any reason whatsoever. I attest that I having read the rules of the virtual race scheduled for November 13-15, 2022 including the terms in this waiver, the timeline of the virtual event, and agree to abide by them. I assume all risks to me associated with running on my own as part of this virtual activity, including but not limited to: falls, contact with other pedestrians, the effects of the weather, including high heat and/or humidity, traffic and the conditions of the road or trail, all such risks being known or unknown and appreciated by me when out running on my own without any type of support from local officials or event organizers. 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 the GAHPERD Inc., all event sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this virtual event, and waive my ability to bring any legal action against the entities outlined in this waiver as I am voluntarily electing to run on my own as part of this virtual event. I grant permission to all of the foregoing to use my photographs which I may share online as part of the event, personal data provided during registration and optional post-event reporting, video or audio recordings, or any other record of this event for any legitimate purpose. I understand that this event does not provide for refunds in the event of a cancellation, and by signing this waiver, I consent that I am not entitled to a refund if the event is cancelled before or during the event. *

REGISTRATION PAYMENT

Registration ends November 12, 2022

Select below to register:

Registration Fees *

2022 Convention 5K Race Registration Adult Tshirt $25.00

2022 Convention 5K Race Registration Child Tshirt $20.00

2022 Convention 5K Race Registration NO Tshirt $0.00

T-shirt size (adult)

T-shirt size (child)

Small

Medium

Large

Extra Large

Selecting "NEXT>>" below will take you to PayPal for payment!