Register Online -- You Can Pay Online too!
If you are paying online, your selected registration items below should always match the ones that you pay for separately on PayPal. If Paying online, pay on PayPal first. Click on the "PayPal Cart" button to complete your online purchase. Then click the "I’m In!" check box and scroll down to continue your online registration.
Registration: Online or Return form and payment to
Page Alliance for Community Action, PO Box 723, Luray, VA 22835
Complete this form (completely! :) to Register Online
Tell us who you are...
Where do you live?
How do we connect with you?
Select your T-shirt Size...
T-Shirt, Youth Extra-Small
T-Shirt, Youth Small
T-Shirt, Youth Medium
T-Shirt, Youth Large
T-Shirt, Youth Extra-Large
T-Shirt, Adult Extra-Small
T-Shirt, Adult Small
T-Shirt, Adult Medium
T-Shirt, Adult Large
T-Shirt, Adult Extra-Large
T-Shirt, Adult Extra-Large x 2
Liability Waiver must be signed to participate in the Luray Earth Day 5K/1K. I recognize that running a road race is a potentially hazardous activity. I should not enter and run unless I am medically able and properly trained. I agree to abide by any decision of a race officials relative to my ability to safely complete the run. I assume all risks associated with running in this event including, but not limited to falls, contact with other participants, the effects of the weather, including cold, snow, and/or ice, high heat and/or humidity, traffic and the conditions of the road, all such risks being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of your accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release the organizers, Page Alliance for Community Action and Page County Public Schools, of the Luray Earth Day 5K/1K on the Greenway, its directors, officers, staff, and volunteers, the town of Luray, and its employees, and all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. Further, I grant permission to all of the foregoing to use any photographs, motion pictures, recordings or any other record of this event for any legitimate purpose. For runner’s safety, I understand that headsets, bicycles, scooters, and roller blades are prohibited. Strollers are allowed.
I ALSO UNDERSTAND THAT THERE ARE NO REFUNDS FOR THIS EVENT. I GIVE PERMISSION TO USE MY PHOTOGRAPH IN FUTURE EARTH DAY RACE PROMOTION.
Type in your Full Legal Name to electronically sign your registration form...