Medal of Honor 5K Registration Form

Your First Name

Your Last Name

Your Email

Your Phone Number

Your Gender
FemaleMale

Your Age
1-14 years15-29 years30-44 years45-59 years60+ years

Your T-shirt Size (adult unisex - first 200 registrants)
smallmediumlargexlargeno shirt

Event Waiver of Liability
By registering and submitting payment, I acknowledge that participation in this event involves physical activity and agree to release the Brevard Veterans Memorial Center, its volunteers, and partners from any liability related to injury, loss, or damage arising from participation in this event. I grant permission to all of the foregoing to use my photographs, motion pictures, recordings or any other record of this event for any legitimate purposes. 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.

I have read the Event Waiver of Liability
Yes