FS Series Loading RaceReach… 05/02/2020 @ 9:00am The Patriot 5k and 1 Mile Fun Run 5K, 1 Mile Run Apex, NC Toggle navigation Register Volunteer Sponsors Participants Results Course Maps Register Overview Overview Location Am I already registered? SIGN IN Registration for The Patriot 5k, Mile Run, Kids Dash The form is loading. Form is loading... Categories* 5k - $25.00 1 Mile Fun Run - $5.00 Participant Information Email * Participant First Name * Participant Last Name * Participant Birthdate * - month - Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec - day - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 - year - 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 Participant Gender * Male Female Country Address * United States Canada Mexico International Street Address * City * State * -- select state -- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Col. Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Virgin Islands Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code * Phone * Would you like to receive important event text alerts on this number (eg. changes or delays)? Emergency Contact Name * Emergency Phone * Make a Donation The Apex Friendship Patriots Athletic Club (Tax ID # - 47-3919430) Donation $ The Apex Friendship Patriots Athletic Club (AFPAC) is a volunteer organization committed to providing the student-athletes at Apex Friendship High School with the very best facilities, equipment, protection and opportunities. In order to provide these opportunities, the Athletic Boosters need to raise approximately 90% of the annual athletic budget at Apex Friendship High School. In addition, we must raise at least $400,000 to ready the facilities for our student athletes and fans, and to plan for the future of the athletic department. We need your help as we continue to develop the Apex Friendship High School athletics program into one of the very best in the state of North Carolina! Donations will help provide the much needed funds to reach our fundraising goals to support immediate sport and facility needs including: u00b7 Irrigation u00b7 Dugouts for the baseball/softball fields u00b7 Lights for the baseball/softball fields Outdoor restrooms to serve baseball/softball fields Waiver READ THIS DOCUMENT (THE "WAIVER AGREEMENT") CAREFULLY BEFORE SIGNING. THIS WAIVER AGREEMENT WILL AFFECT YOUR LEGAL RIGHTS AND WILL LIMIT OR ELIMINATE YOUR ABILITY TO BRING A FUTURE LAWSUIT. RELEASE AND WAIVER OF LIABILITY AGREEMENT Undersigned athlete (“Athlete”) on behalf of himself/herself and on behalf of Athlete’s personal representatives, assigns, heirs, executors, and successors hereby fully and forever releases, waives, discharges and covenants not to sue FS Series, its affiliated corporations and charities, the host city(ies), county and state, USATF, any and all municipal agencies whose property and/or personnel are used or in any way assist, all sponsoring or co-sponsoring companies or individuals related to the Event, together with their officers, directors, shareholders, successors and assigns, (collectively “Releases”) from all liability to the Athlete, his/her personal representatives, assigns, heirs, executors, and successors for any and all loss(es), damage(s), and any and all claims or demands therefore, account of injury to Athlete, his/her property or resultant death, whether caused by the active or passive negligence of all or any of the Releases or otherwise, in connection with Athlete’s participation in the Event. Athlete represents and warrants that he/she is in good physical condition and is able to safely participate in the Event. Athlete is fully aware of the risks and hazards inherent in participating in the Event and hereby elects to voluntarily participate, knowing the risks associated with the Event. Athlete hereby assumes all risks of loss(es), damage(s), or injury(ies) that may be sustained by him/her while participating in the Event. Athlete agrees to the use of his/her name and photograph in broadcasts, newspapers, brochures and other media without compensation. Athlete acknowledges that the entry fee paid is non-refundable and non-transferable. Athlete acknowledges and agrees that the "Event" and FS Series in its sole discretion, may delay or cancel the Event if it believes the conditions on race day are unsafe. In the event the Event is delayed or cancelled for any reason, including but not limited to: fire, threatened or actual strike, labor difficulty, work stoppage, insurrection, war, public disaster, flood, unavoidable casualty, acts of God or the elements (including without limitation, rain, hail, hurricane, tornado, earthquake), or any other cause beyond the control of the "Event" and FS Series. There shall be no refund of the entry fee or any other costs of Athlete in connection with the Event. The Athlete hereby grants to The Medical Staff of the Event, and his/her agents, affiliates and designees, access to all medical records (and physicians) as needed and authorizes medical treatment as needed. Athlete understands that they have the rights to refuse medical care and advice of Event medical directors and representatives; if Athlete’s medical condition becomes such that the Athlete’s mental capacity is questioned, the physician has the right to recommend and initiate treatment of Athlete. It is understood and agreed that Athlete hereby assumes liability for any and all medical expenses incurred as a result of training for and/or participation in the Event, including but not limited to ambulance transport, hospital stays, physician and pharmaceutical goods and services. Athlete warrants that all statements made herein are true and correct and understands that Releasees have relied on them in allowing Athlete to participate in the Event. I understand that bicycles, skate boards, roller skates or inline skates, animals and musical devices of any type are not allowed in this event and I will abide by this rule. The parent or legal guardian who signs the Waiver Agreement on behalf of a minor, incapacitated and/or mentally challenged person (hereinafter "Said Person"), hereby acknowledges that he or she has the legal capacity and authority to act on behalf of Said Person to legally bind Said Person to the Waiver Agreement. The parent or legal guardian who signs the Waiver Agreement agrees to indemnify and hold harmless the Released Parties for any expenses incurred, Claims made, or liabilities assessed against them, as a result of any insufficiency of legal capacity or authority to act on behalf of Said Person in the execution of the Waiver Agreement. FS Series reserves the rights to use your email address for FS marketing only and releases your information to event photographer for photos. If any provision of this Waiver Agreement shall be unlawful, void, or for any reason unenforceable, then that provision shall be deemed severable from this Waiver Agreement and shall not affect the validity and enforceability of any remaining provisions. THE PARTICIPANT FULLY UNDERSTANDS THE FOREGOING CONDITIONS OF THE EVENT. BY CHECKING YES, THE PARTICIPANT HAS READ AND FULLY UNDERSTANDS THE WAIVER AGREEMENT. Read through the agreement I have read and agreed to the waiver * Is the participant 18 or older? * 18 or older Under 18 Parent or Legal Guardian’s Signature - By providing your electronic signature you agree that you have the authority to register these participants and agree to the waiver(s) for them as their parent or legal guardian. If registering a child under 18, you are consenting to the collection of the child's information that you are providing for the purposes of registration. Parent's signature Payment Details Discount, Tracking, or Charity Code Apply Price $ Discount (-) $ Donation $ Totalno handling $ Handling $ Total $ Payment Method The payment and credit card section is not visible because there is nothing owed or form fields have not been fully completed. Visa/Mastercard Credit Card # Exp. Date MM 01 02 03 04 05 06 07 08 09 10 11 12 / YY 19 20 21 22 23 24 25 26 27 28 29 CVV Code Your payment is encrypted and 100% secure. Payable To: Address: click the "pay now" button to submit your order then send a check (or pay in person) at the address above. 1. Venmo the total amount to the Phone #: 2. Make sure you enter the code, 40941 in "What's it for". 3. Click the "pay now" button. Enter a Check Number Enter a Check Amount Do you want to send email receipt to the participant Purchase Purchase Cancel The Patriot 5k and 1 Mile Fun Run SPONSORS Platinum SponsorLeith VW Learn more Just a moment...