This is a 2 Part REGISTRATION, PLEASE READ!

Once you’ve filled out pt 1, you will be redirected to the add your event(s) to cart then check out with payment submission. you will need to add all submissions to cart then check out via cart icon!

This form must be filled out and submitted for EACH participant. If you are signing multiple people up, please submit each form before “adding to cart”

PART 1 | FORM COMPLETION & SUBMISSION
(1 per participant, no group forms!)

Name

First Name

Last Name

Phone

(###)

###

####

Date of Birth

YYYY

Event Type:

If you select walk, you are not allowed to run at any time.

Gender

Male

Female

T-Shirt SIze

Deadline to ensure tshirt and your correct t-shirt size is 3/31/2026- all registrations submitted after will be best match based on stock. Participant packages include a race day t-shirt, please select your sizing. (typically gildan brand) If you do not want a t-shirt and wish to donate the cost of your shirt towards Reshma's Home, please select *donate*

Weather & Cancellation Policy Agreement

By selecting "I AGREE", I understand and agree that there may be a cancellation or postponing of event due to weather or other unforeseen circumstance and will not require a refund or any other form of credit for this paid event.

I Agree

I do not wish to participate

Liability Waiver & Release Signature

By submitting this form electronically, with my typed signature, I am agreeing that I am able and willing to run/walk at my own risk and will not hold any of the following parties responsible for any injury, theft, sickness or other unforeseen circumstances: including but not limited to: Reshma's Home's partners, sponsors, volunteers board members and/or staff, the City of Gluckstadt, the County of Madison/Canton, the police offers, fire fighters and other first responders. I understand the risk, and I am in full acceptance of my own liability and will hold no one at blame/fault for any unforeseen circumstances. By electronically signing this, I agree that I am responsible for all liabilities for myself and for my family. I will not hold Reshma's Home, The City of Gluckstadt or any participating Sponsor/Partner liable for injury or illness. I (parent/guardian if minor) hereby certify the following: I have no medical restrictions prohibiting from participating in the Reshma’s Home Fun Run, 5K and Block Party (including use of bounce inflatables) on May 2, 2026. As a participant, I waive and forever discharge the organizer, sponsors, and any other event volunteer from any and all claims that may occur as a result of my participation.