Step 1 of 4 (Registration Agreement)

LIVEFIT / TBK Autoimmune Awareness 5K & 10K

Saturday, June 12, 2021 in Bettendorf, IA at TBK Bank Sports Complex -

  • 10K
    Registration includes: a complimentary breakfast, tshirt, Unlimited 30 minute Arcade Card at High 5!

  • 5K Run/Walk
    Registration includes: a complimentary breakfast, tshirt, Unlimited 30 minute Arcade Card at High 5!

  • Sleep In and Make a Contribution.
    This category does not include a race registration.

  • Virtual Participation
    Note: this is NOT an "in-person" event entry. Select your distance on step 2.

  • Sponsor Options
    See below for level details

* Click here for fee information

Terms & Conditions

Refunds: All registrations are final, no refunds.

By indicating your acceptance, you understand, agree, warrant and covenant as follows:
By submitting this Entry Form, I represent to LIVEFIT With Lupus, Inc. ("LFWL") and to the TBK AUTOIMMUNE AWARENESS RACE, LIVEFIT With Lupus Run/Walk ("Event") that I understand and agree to the following:
1. I have full legal authority to complete this Entry Form on behalf of myself, including full authority to make use of the credit or debit card to which registration fees will be charged. If I am registering an individual under the age of 18 or an incapacitated adult, I represent and warrant that I am the parent or legal guardian of that party and have the full legal authority to submit this Entry Form on their behalf and by proceeding with this event registration, I agree that the terms and conditions of this Entry Form will apply equally to all participants of the TBK AUTOIMMUNE AWARENESS RACE and LIVEFIT WITH LUPUS.
2. I understand that participation in the Run is potentially hazardous and that I should not participate unless I am medically able to and properly trained for the Run. I understand that the Race course may be held over public roads and hazardous conditions are to be expected. I further understand that participation in the Run contains risks that cannot be fully eliminated including, minor or catastrophic injuries, impact of weather conditions, altitude or unforeseen acts by third parties.
3. I will abide by any decision of any race official, before or during the Race, relative to my ability to safely participate. I agree that my failure to honestly represent my ability to participate in the Race or accept the conditions of participation stated above and in the Race rules and procedures may result in my disqualification from participation. I grant to the Medical Director of this event and his designee access to my medical records and physicians, as well as other information, relating to medical care that may be administered to me as a result of my participation in the Race.
4. To maintain my safety and those of other participants and individuals involved in the Race, I must and shall participate in the Race alone, unassisted, and without the aid of any person, animal, or device, unless I am participating as a disabled individual. I understand that the use of personal audio devices (iPods or MP3 headsets) during the Race is strongly discouraged.
5. I hereby assume all risks and liabilities that may be associated with and/or result from my participation in the Race involvement in or attendance at the Event, including travel to and from the Event. I acknowledge and agree that I many not recover from any individual or company associated with the Event (including, without limitation LFWL and each of their respective parent companies, subsidiaries, sponsors, affiliates, officers, directors, agents, servants and employees (collectively, "Releasees")) for any injury or damage to any person or property resulting from any of the activities pertaining, directly or indirectly, to the Race (or any portion thereof), and I hereby release, to the fullest extent permitted by the law, and agree to indemnify and hold harmless the Releasees from and against any liability, claims, demands, actions, causes of action, losses, damage, injuries (including death) that may be sustained by me or by others on account of me as a result of my participation in or attendance at the Run regardless of whether any such loss, damage or injury is the result of negligence and/or breach of warranty (express or implied) on the part of the Releasees.
6. I authorize personnel for the Race, TBK Bank and LFWL to call medical care for me and/or to transport me to a medical facility or hospital of their choosing if, in the opinion of such personnel, medical attention is needed. I agree that LFWL & TBK Bank shall have any responsibility for calling for or transporting me to medical care, and I shall indemnify and hold harmless the Releasees from and against any costs incurred in any effort to provide me with, or transport me to a place to receive, medical attention.
7. I hereby grant LFWL & TBK Bank (and their affiliates and licensees) the irrevocable, transferable, perpetual. royalty-free right and license throughout the universe to record (by photographs, film, tape, aural devices and any other method or device) my attendance (including my name, voice, image and/or likeness) at the Race (the "Recordings"), and use, modify, copy, distribute and exploit such Recordings for any and all purposes, in any and all media, formats and methods of transmission now known or hereafter developed.
8. I hereby covenant not to sue any of the Releasees. This release shall be binding upon the assignees, distributees, heirs, next of kin, executors and administrators of the undersigned and may be pled by LFWL and/or the other Releasees as a complete bar and defense against any claims, demand, action or cause of action by or on behalf of the undersigned.
I have carefully read this agreement, and I know and understand what it means. My signature below is of my own free act and I intend it to be legally binding upon me. This agreement represents the entire understanding between LFWL and me regarding the subject matter hereof and supersedes any other statements, agreements or representations, whether written or oral regarding the subject matter. I agree that, if any portion of this agreement is determined to be unenforceable by a court of law, the court should enforce the remainder of this agreement without regard to such provision.

Privacy Policy

LIVEFIT With Lupus, Inc. ("LFWL") respects the privacy and confidentiality of individuals who visit the LFWL website located at LFWL maintains this Privacy Policy to inform you about our policies and procedures regarding the collection, use, security, and disclosure of personally identifiable information and other information received from users of the website. This Privacy Policy may be updated or revised from time to time. We may do so, at any time and without notice, by posting the revised version on this website. We suggest that you review this Privacy Policy periodically for any such changes.
By using the LFWL website, you consent to the collection and use of information by LFWL. If you do not agree with the terms and conditions stated in this Privacy Policy, please do not access or use the LFWL website. This Privacy Policy does not apply to any third-party site that may be accessible through this website.

Collection of Your Personal Information by LFWL

LFWL's mission is to provide you with personalized services and offerings designed to enhance your experience. To do so effectively, this website facilitates your sending of personally identifiable information to LFWL, such as your name, telephone number, postal address or email address. The provision of any such information by you is completely voluntary. If you do not wish your personally identifiable information to be collected, please do not submit it. Please do not send any information that is sensitive or confidential.

When you visit our site, we may collect information sent to us automatically by your web browser. This information typically includes your Internet Protocol (IP) address, the identity of your internet service provider, the name and version of your operating system, the name and version of your web browser, the "referring" website from which you initially entered this website, the date and time of your visit, and the pages you visit.

The LFWL website employs "cookie" technology. Cookies are small pieces of data stored in files on your computer allowing LFWL to track your use of the website as you visit and revisit the website. The use of cookies by the LFWL website complies with generally accepted programming standards and practices. Please note that you can choose to block the use of cookies through settings in your web browser, but certain features of the LFWL website may not work properly without them.

Use of Your Information by LFWL

We do not sell, share or otherwise disclose the personally identifiable information you provide through this website except as follows: (i) disclosures to third parties who perform services on our behalf, such as those who monitor the website and those who assist in preparing mailings. We reserve the right to use and share any information to investigate illegal conduct or violations of the Terms of Use governing this website, to comply with legal process, to assist law enforcement agencies, or if we believe in good faith it is required by law. LFWL routinely collects, compiles, and reports statistics and information reflecting the use of the LFWL website and information services in order to enhance membership services, improve marketing and promotional efforts, analyze LFWL website usage, improve the website's content and layout, generate aggregate reports on trends, interests and behavior and enhance service offerings.
We take reasonable precautions to provide a level of security appropriate to the sensitivity of the personally identifiable information you provide through this website. While we take reasonable measures to ensure the security of this information, we cannot guarantee the security of the information provided over the internet or stored in our databases. Your transmissions are, therefore, at your own risk.

Changing and Deleting Your Personal Information

You may request that LFWL change or delete your personal information from the LFWL database by submitting a detailed description of the desired action to the following e-mail address: Please note that, after LFWL processes a change or deletes your personal information from active LFWL systems and databases, it is possible that non-active residual copies of your information may still exist in LFWL systems and on archive or backup media.

Electronic Newsletters

We offer free, electronic newsletters, updates and e-mail reminders as a service to our registrants, based upon your voluntary subscription. You will only receive an electronic newsletter if you have requested it (opted-in).

Governing Law

This Privacy Policy shall be governed under the laws of the State of Iowa without regard to its conflicts of law provisions.

Your Questions and Concerns

If you have questions or concerns about this Privacy Policy or any of LFWL's use of your information, please contact LFWL at the following e-mail address:

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 4:25:43 PM EDT on 05/14/2021.

Click here to print the agreement.

You are encouraged to keep a copy of this agreement for your records. This agreement was generated at 4:25:43 PM EDT on 05/14/2021

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