Register to Participate in the 10K/5K Run & Walk!

5K RunnersRegistration Fee

  • 10K Run Registration: $30 per person
  • 5K Run or Walk: $25 per person
  • 1-Mile Fun Run: $15 per person
T-shirt is guaranteed to all who pre-registered by the original race date of March 14, 2020.

Proceeds are used to benefit all client programs including behavioral health, supportive living, and developmental services to individuals residing in the Southern 7 counties of Illinois.


Rain or Shine — Sorry NO Refunds!

10K/5K REGISTRATION FORM

    Note: After completing the form and clicking the "Submit" button, you will be taken to PayPal to complete your payment transaction.
  • FAMILY COUNSELING CENTER, INC. HOLD HARMLESS AGREEMENT TO PARTICIPATE IN GROUP ACTIVITIES DURING COVID-19

  • By signing this agreement, I acknowledge the contagious nature of COVID-19 and on behalf of myself and/or the client named above, voluntarily assume the risk that I and/or the client named above may be exposed to or infected by COVID-19 by attending group activities at any Family Counseling Center, Inc. location or within the community that is led by Family Counseling Center, Inc.

    I voluntarily agree to assume all risks and accept sole responsibility for any injury to myself and/or the client named above including, but not limited to, personal injury, disability, death, illness, damage, loss, claim, liability, or expense, of any kind, that I and/or the client named above may experience or incur in connection with my and/or the client named above attendance in activities or participation in Family Counseling Center, Inc. programming.

    On my behalf and/or the client named above, I will advance no claim and I hereby release, covenant not to sue, discharge, defend, indemnify and hold harmless Family Counseling Center, Inc., its employees, agents, and representatives, of and from the claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto.

    I understand and agree that this release includes any claims based on the actions, omissions, or negligence of Family Counseling Center, Inc., its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any activity.

  • Waiver: I have signed this entry form intending to be legally bound, hereby to myself, my heirs, executors, and administrators and release any and all rights and claims for damages I might have against the organizers of this race and officials and other sponsors of this event and their representatives for any and all injuries suffered by me in the event. I attest that I am physically fit and have sufficiently trained for the event and a licensed medical doctor has verified my physical condition. Furthermore, I hereby grant full permission to any and all of the foregoing to use my photograph or any other record of this event for any legitimate purpose. This entry is invalid unless signed by the entrant. If entrant is under 18 years of age then entry must be signed by a parent or guardian. The official race director reserves the right to reject any entry.
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