"An information highway for victims of domestic abuse."™ 

PARTICIPANTS REGISTRATION FORM
First Name                    M I     Last Name
Gender  
Birthdate
Age on race day
Email
Day Phone
Address
Which event are you participating in?
5k
Emergency Contact
First Name                 Last Name
Phone
T-Shirt Size
WARNING: READ CAREFULLY. THIS AGREEMENT INCLUDES A RELEASE OF
LIABILITY AND WAIVER OF LEGAL RIGHTS AND DEPRIVES YOU OF THE RIGHT TO SUE THIS EVENT AND OTHER PARTIES. DO NOT SIGN THIS AGREEMENT UNLESS YOU HAVE READ IT IN ITS ENTIRETY. SEEK THE ADVICE OF LEGAL COUNSEL IF YOU ARE UNSURE OF ITS EFFECT.
I understand that my consent to these provisions is given in consideration of the acceptance of this registration and for being permitted to participate in this event. I am a voluntary participant in this event, and in good physical condition. I have been advised that I should seek advice from my physician before undertaking this physical exercise. I have either visited with my physician and received doctor's advice and consent to my exercise program or have waived such advice and consent of my doctor, and except any and all risks.
I KNOW THAT THIS EVENT IS A POTENTIALLY HAZARDOUS ACTIVITY AND I HEREBY ASSUME FULL AND COMPLETE RESPONSIBILITY FOR ANY INJURY OR ACCIDENT WHICH MAY OCCUR DURING MY PARTICIPATION IN THIS EVENT OR WHILE ON THE PREMISES OF THIS EVENT, AND I HEREBY RELEASE AND HOLDHARMLESS AND IMGF OR SPONSORS NOT TO FILE SUIT AGAINST THIS EVENT AND ANY AFFILIATED INDIVIDUALS OR ENTITIES ASSOCIATED WITH THIS EVENT (THE RELEASEES) FROM ANY LOSS, LIABILITY OR CLAIMS I MAY HAVE ARISING OUT OF MY PARTICIPATION IN THIS EVENT, INCLUDING PERSONAL INJURY OR DAMAGE SUFFERED BY ME OR OTHERS, WHETHER SAME BE CAUSED BY FALLS, CONTACT WITH PARTICIPANTS, CONDITIONS OF THE COURSE, NEGLIGENCE OF THE RELEASEES OR OTHERWISE.
I understand that this Waiver and Release may be stored electronically and agree that a copy is authentic and admissible as evidence in any future dispute or proceedings. If I do not follow all the rules of this event, I understand that I may be removed from the competition. I give my full permission to this event and their sponsors and corporate sponsors to use any photographs, videotapes or other recordings of me that are made during the course of this event. I have read, understood, and accept the agreement above. My submission of this form shall act as my legal signature.

We proudly support
Shelter organizations
Your participation will not go unnoticed. Your monies will help the following shelters throughout the metroplex:


If you feel you have been abused please phone:
NATIONAL DOMESTIC VIOLENCE HOTLINE
1/800-899-7233 OR 1/800-787-3244

Please read the WARNING below carefully as it contains an agreement including a release of liability and waiver of legal rights and deprives you of the right to sue this event and other parties.  You will be able to submit your payment after you click the SUBMIT-I AGREE button.
Submit one registration per person.
CLICK HERE TO MAKE YOUR PAYMENT AFTER YOU 
SUBMIT-I AGREE BELOW.
Ina Mae Greene Foundation "For My Sisters"
4116 S. Carrier PKY #280
Grand Prairie, TX 75052
United States
ph: 972-290-0742
fax: 972-346-6254
DISCLAIMER
The information contained on this website is for information and educational purposes only and do not constitute legal or medical advice.  We are not doctors, lawyers or law enforcement.   Please do not use the information you read here as a replacement for either.  Do not rely solely on what you read here to determine how you will leave your abuser. Contact a shelter, police, or victims’ service organization for help with safety planning and more information on how to leave an abusive relationship.  
Copyright 2009-2018 Ina Mae Greene Foundation "For My Sisters" All rights reserved.  A 501c3 Foundation.
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Female
$25
1 Mile Walk/Run
$15
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