Chickasaw Wellness Complex Heartland Days 5K Fun Run & Walk

Saturday, June 14, 2025 at Mikkelson Park in New Hampton, IA

What category would you like to sign up for? You can sign up for any of the following categories.

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Waiver

I hereby declare myself in good physical condition and able to run or walk in the CWC 5K Run/Walk event. I do hereby waive and release the Chickasaw Wellness Complex, City of New Hampton, individuals associated with this event, their agents, representatives, and successors, from claims for damages of any nature, including personal injury that I may incur as a result of my participation.

Please Sign Below

Your electronic signature is the online equivalent of your ink-on-paper signature, and can be provided by typing your name where indicated. The electronic signature will signify your understanding, acceptance, and authorization to accept the conditions of this legal document, including the following statements:

  • I have read, have understood, and do accept the agreement above.
  • I understand that this is a legal document with effects that I approve and authorize.
  • The registrant is the person(s) whose name is submitted as the recipient of the goods and services provided as a result of this transaction.
  • I am authorized to agree to the terms of this document on behalf of the registrant.
  • If the registrant is under 18 years of age, incapacitated, or mentally challenged, I assert that I am the parent/legal guardian or otherwise authorized to execute a legally binding agreement on behalf of the registrant.

Electronic Signature

You must be 18 years of age to legally complete this registration. If the registrant is under 18, an authorized adult must complete this form.
If the person you are registering (registrant) is under 18, do not enter his/her age. You will do that on the next step. Enter your age here as the person completing the form.




Multiple signers should separate their signatures with commas.


This agreement was generated at 5:00:19 AM EDT on 04/20/2025.