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- 5K/Family Fun Registration
  
  The maximum number of form submissions has been reached. This form is currently not available.
  
  Family Contact
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  For planning purposes, please indicate any activities in which you/your family is interested in participating.
  Please note - You are welcome to join any and all activites, even if not marked here.
  
  Activities of Interest REQUIRED 5K Family Day Activities/Lunch 5K Race Please fill out this field.
  
  If lunch is checked, how many will be joining us? REQUIRED Please fill out this field. Please enter an integer (number).
  
  Number of 5K Race Participants - walkers or runners - including yourself REQUIRED Please fill out this field.
  
  Participant 1
  
  The following information is required for each 5K participant, collected for the tabulation of race results and for the awarding of prizes.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of Birth - MM/DD/YYYY REQUIRED Please fill out this field. Please enter a date.
  
  Waiver for St Rose 5K
  Please enter me in the Saint Rose of 2022 Lima 5K.
  I agree to assume all responsibility for all risk of damage or injury to me as a participant in this event. In consideration of being accepted as an entrant in the Saint Rose of Lima 5K I hereby, for myself, my heirs, executors and administrators, release and discharge Saint Rose of Lima Parish, Central Mass Striders, and any and all other individuals, entities, and organizations associated with the race from all claims, damages, rights of action, present or future, whether the same be known, anticipated, or unanticipated resulting from or arising out of, or in incident to, my participation in the event. I hereby certify that I will not participate in Saint Rose of Lima 5K unless I am physically fit and sufficiently trained for competition in the race. I also grant permission for the use of my name and or picture in any broadcast, photograph or other account of this race. I understand that bicycles, skateboards, roller skates or blades, animals, and radio headsets are not allowed in the race and I abide by this guideline. I also agree that I will participate in the full distance of the race and will not take any deviation off the course. To do so could result in immediate disqualification if validated.
  
  I Agree Please select this field.
  
  Signature of Parent/Guardian - if participant is under age 18):
  
  Participant 2
  
  The following information is required for each 5K participant, collected for the tabulation of race results and for the awarding of prizes.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of Birth - MM/DD/YYYY REQUIRED Please fill out this field. Please enter a date.
  
  Waiver for St Rose 5K
  Please enter me in the Saint Rose of 2022 Lima 5K.
  I agree to assume all responsibility for all risk of damage or injury to me as a participant in this event. In consideration of being accepted as an entrant in the Saint Rose of Lima 5K I hereby, for myself, my heirs, executors and administrators, release and discharge Saint Rose of Lima Parish, Central Mass Striders, and any and all other individuals, entities, and organizations associated with the race from all claims, damages, rights of action, present or future, whether the same be known, anticipated, or unanticipated resulting from or arising out of, or in incident to, my participation in the event. I hereby certify that I will not participate in Saint Rose of Lima 5K unless I am physically fit and sufficiently trained for competition in the race. I also grant permission for the use of my name and or picture in any broadcast, photograph or other account of this race. I understand that bicycles, skateboards, roller skates or blades, animals, and radio headsets are not allowed in the race and I abide by this guideline. I also agree that I will participate in the full distance of the race and will not take any deviation off the course. To do so could result in immediate disqualification if validated.
  
  I Agree Please select this field.
  
  Signature of Parent/Guardian - if participant is under age 18):
  
  Participant 3
  
  The following information is required for each 5K participant, collected for the tabulation of race results and for the awarding of prizes.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of Birth - MM/DD/YYYY REQUIRED Please fill out this field. Please enter a date.
  
  Waiver for St Rose 5K
  Please enter me in the Saint Rose of 2022 Lima 5K.
  I agree to assume all responsibility for all risk of damage or injury to me as a participant in this event. In consideration of being accepted as an entrant in the Saint Rose of Lima 5K I hereby, for myself, my heirs, executors and administrators, release and discharge Saint Rose of Lima Parish, Central Mass Striders, and any and all other individuals, entities, and organizations associated with the race from all claims, damages, rights of action, present or future, whether the same be known, anticipated, or unanticipated resulting from or arising out of, or in incident to, my participation in the event. I hereby certify that I will not participate in Saint Rose of Lima 5K unless I am physically fit and sufficiently trained for competition in the race. I also grant permission for the use of my name and or picture in any broadcast, photograph or other account of this race. I understand that bicycles, skateboards, roller skates or blades, animals, and radio headsets are not allowed in the race and I abide by this guideline. I also agree that I will participate in the full distance of the race and will not take any deviation off the course. To do so could result in immediate disqualification if validated.
  
  I Agree Please select this field.
  
  Signature of Parent/Guardian - if participant is under age 18):
  
  Participant 4
  
  The following information is required for each 5K participant, collected for the tabulation of race results and for the awarding of prizes.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of Birth - MM/DD/YYYY REQUIRED Please fill out this field. Please enter a date.
  
  Waiver for St Rose 5K
  Please enter me in the Saint Rose of 2022 Lima 5K.
  I agree to assume all responsibility for all risk of damage or injury to me as a participant in this event. In consideration of being accepted as an entrant in the Saint Rose of Lima 5K I hereby, for myself, my heirs, executors and administrators, release and discharge Saint Rose of Lima Parish, Central Mass Striders, and any and all other individuals, entities, and organizations associated with the race from all claims, damages, rights of action, present or future, whether the same be known, anticipated, or unanticipated resulting from or arising out of, or in incident to, my participation in the event. I hereby certify that I will not participate in Saint Rose of Lima 5K unless I am physically fit and sufficiently trained for competition in the race. I also grant permission for the use of my name and or picture in any broadcast, photograph or other account of this race. I understand that bicycles, skateboards, roller skates or blades, animals, and radio headsets are not allowed in the race and I abide by this guideline. I also agree that I will participate in the full distance of the race and will not take any deviation off the course. To do so could result in immediate disqualification if validated.
  
  I Agree Please select this field.
  
  Signature of Parent/Guardian - if participant is under age 18):
  
  Participant 5
  
  The following information is required for each 5K participant, collected for the tabulation of race results and for the awarding of prizes.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of Birth - MM/DD/YYYY REQUIRED Please fill out this field. Please enter a date.
  
  Waiver for St Rose 5K
  Please enter me in the Saint Rose of 2022 Lima 5K.
  I agree to assume all responsibility for all risk of damage or injury to me as a participant in this event. In consideration of being accepted as an entrant in the Saint Rose of Lima 5K I hereby, for myself, my heirs, executors and administrators, release and discharge Saint Rose of Lima Parish, Central Mass Striders, and any and all other individuals, entities, and organizations associated with the race from all claims, damages, rights of action, present or future, whether the same be known, anticipated, or unanticipated resulting from or arising out of, or in incident to, my participation in the event. I hereby certify that I will not participate in Saint Rose of Lima 5K unless I am physically fit and sufficiently trained for competition in the race. I also grant permission for the use of my name and or picture in any broadcast, photograph or other account of this race. I understand that bicycles, skateboards, roller skates or blades, animals, and radio headsets are not allowed in the race and I abide by this guideline. I also agree that I will participate in the full distance of the race and will not take any deviation off the course. To do so could result in immediate disqualification if validated.
  
  I Agree Please select this field.
  
  Signature of Parent/Guardian - if participant is under age 18):
  
  Participant 6
  
  The following information is required for each 5K participant, collected for the tabulation of race results and for the awarding of prizes.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of Birth - MM/DD/YYYY REQUIRED Please fill out this field. Please enter a date.
  
  Waiver for St Rose 5K
  Please enter me in the Saint Rose of 2022 Lima 5K.
  I agree to assume all responsibility for all risk of damage or injury to me as a participant in this event. In consideration of being accepted as an entrant in the Saint Rose of Lima 5K I hereby, for myself, my heirs, executors and administrators, release and discharge Saint Rose of Lima Parish, Central Mass Striders, and any and all other individuals, entities, and organizations associated with the race from all claims, damages, rights of action, present or future, whether the same be known, anticipated, or unanticipated resulting from or arising out of, or in incident to, my participation in the event. I hereby certify that I will not participate in Saint Rose of Lima 5K unless I am physically fit and sufficiently trained for competition in the race. I also grant permission for the use of my name and or picture in any broadcast, photograph or other account of this race. I understand that bicycles, skateboards, roller skates or blades, animals, and radio headsets are not allowed in the race and I abide by this guideline. I also agree that I will participate in the full distance of the race and will not take any deviation off the course. To do so could result in immediate disqualification if validated.
  
  I Agree Please select this field.
  
  Signature of Parent/Guardian - if participant is under age 18):
  
  Participant 7
  
  The following information is required for each 5K participant, collected for the tabulation of race results and for the awarding of prizes.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of Birth - MM/DD/YYYY REQUIRED Please fill out this field. Please enter a date.
  
  Waiver for St Rose 5K
  Please enter me in the Saint Rose of 2022 Lima 5K.
  I agree to assume all responsibility for all risk of damage or injury to me as a participant in this event. In consideration of being accepted as an entrant in the Saint Rose of Lima 5K I hereby, for myself, my heirs, executors and administrators, release and discharge Saint Rose of Lima Parish, Central Mass Striders, and any and all other individuals, entities, and organizations associated with the race from all claims, damages, rights of action, present or future, whether the same be known, anticipated, or unanticipated resulting from or arising out of, or in incident to, my participation in the event. I hereby certify that I will not participate in Saint Rose of Lima 5K unless I am physically fit and sufficiently trained for competition in the race. I also grant permission for the use of my name and or picture in any broadcast, photograph or other account of this race. I understand that bicycles, skateboards, roller skates or blades, animals, and radio headsets are not allowed in the race and I abide by this guideline. I also agree that I will participate in the full distance of the race and will not take any deviation off the course. To do so could result in immediate disqualification if validated.
  
  I Agree Please select this field.
  
  Signature of Parent/Guardian - if participant is under age 18):
  
  Participant 8
  
  The following information is required for each 5K participant, collected for the tabulation of race results and for the awarding of prizes.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of Birth - MM/DD/YYYY REQUIRED Please fill out this field. Please enter a date.
  
  Waiver for St Rose 5K
  Please enter me in the Saint Rose of 2022 Lima 5K.
  I agree to assume all responsibility for all risk of damage or injury to me as a participant in this event. In consideration of being accepted as an entrant in the Saint Rose of Lima 5K I hereby, for myself, my heirs, executors and administrators, release and discharge Saint Rose of Lima Parish, Central Mass Striders, and any and all other individuals, entities, and organizations associated with the race from all claims, damages, rights of action, present or future, whether the same be known, anticipated, or unanticipated resulting from or arising out of, or in incident to, my participation in the event. I hereby certify that I will not participate in Saint Rose of Lima 5K unless I am physically fit and sufficiently trained for competition in the race. I also grant permission for the use of my name and or picture in any broadcast, photograph or other account of this race. I understand that bicycles, skateboards, roller skates or blades, animals, and radio headsets are not allowed in the race and I abide by this guideline. I also agree that I will participate in the full distance of the race and will not take any deviation off the course. To do so could result in immediate disqualification if validated.
  
  I Agree Please select this field.
  
  Signature of Parent/Guardian - if participant is under age 18):
  
  Participant 9
  
  The following information is required for each 5K participant, collected for the tabulation of race results and for the awarding of prizes.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of Birth - MM/DD/YYYY REQUIRED Please fill out this field. Please enter a date.
  
  Waiver for St Rose 5K
  Please enter me in the Saint Rose of 2022 Lima 5K.
  I agree to assume all responsibility for all risk of damage or injury to me as a participant in this event. In consideration of being accepted as an entrant in the Saint Rose of Lima 5K I hereby, for myself, my heirs, executors and administrators, release and discharge Saint Rose of Lima Parish, Central Mass Striders, and any and all other individuals, entities, and organizations associated with the race from all claims, damages, rights of action, present or future, whether the same be known, anticipated, or unanticipated resulting from or arising out of, or in incident to, my participation in the event. I hereby certify that I will not participate in Saint Rose of Lima 5K unless I am physically fit and sufficiently trained for competition in the race. I also grant permission for the use of my name and or picture in any broadcast, photograph or other account of this race. I understand that bicycles, skateboards, roller skates or blades, animals, and radio headsets are not allowed in the race and I abide by this guideline. I also agree that I will participate in the full distance of the race and will not take any deviation off the course. To do so could result in immediate disqualification if validated.
  
  I Agree Please select this field.
  
  Signature of Parent/Guardian - if participant is under age 18):
  
  Participant 10
  
  The following information is required for each 5K participant, collected for the tabulation of race results and for the awarding of prizes.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of Birth - MM/DD/YYYY REQUIRED Please fill out this field. Please enter a date.
  
  Waiver for St Rose 5K
  Please enter me in the Saint Rose of 2022 Lima 5K.
  I agree to assume all responsibility for all risk of damage or injury to me as a participant in this event. In consideration of being accepted as an entrant in the Saint Rose of Lima 5K I hereby, for myself, my heirs, executors and administrators, release and discharge Saint Rose of Lima Parish, Central Mass Striders, and any and all other individuals, entities, and organizations associated with the race from all claims, damages, rights of action, present or future, whether the same be known, anticipated, or unanticipated resulting from or arising out of, or in incident to, my participation in the event. I hereby certify that I will not participate in Saint Rose of Lima 5K unless I am physically fit and sufficiently trained for competition in the race. I also grant permission for the use of my name and or picture in any broadcast, photograph or other account of this race. I understand that bicycles, skateboards, roller skates or blades, animals, and radio headsets are not allowed in the race and I abide by this guideline. I also agree that I will participate in the full distance of the race and will not take any deviation off the course. To do so could result in immediate disqualification if validated.
  
  I Agree Please select this field.
  
  Signature of Parent/Guardian - if participant is under age 18):
  
  Participant 11
  
  The following information is required for each 5K participant, collected for the tabulation of race results and for the awarding of prizes.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of Birth - MM/DD/YYYY REQUIRED Please fill out this field. Please enter a date.
  
  Waiver for St Rose 5K
  Please enter me in the Saint Rose of 2022 Lima 5K.
  I agree to assume all responsibility for all risk of damage or injury to me as a participant in this event. In consideration of being accepted as an entrant in the Saint Rose of Lima 5K I hereby, for myself, my heirs, executors and administrators, release and discharge Saint Rose of Lima Parish, Central Mass Striders, and any and all other individuals, entities, and organizations associated with the race from all claims, damages, rights of action, present or future, whether the same be known, anticipated, or unanticipated resulting from or arising out of, or in incident to, my participation in the event. I hereby certify that I will not participate in Saint Rose of Lima 5K unless I am physically fit and sufficiently trained for competition in the race. I also grant permission for the use of my name and or picture in any broadcast, photograph or other account of this race. I understand that bicycles, skateboards, roller skates or blades, animals, and radio headsets are not allowed in the race and I abide by this guideline. I also agree that I will participate in the full distance of the race and will not take any deviation off the course. To do so could result in immediate disqualification if validated.
  
  I Agree Please select this field.
  
  Signature of Parent/Guardian - if participant is under age 18):
  
  Participant 12
  
  The following information is required for each 5K participant, collected for the tabulation of race results and for the awarding of prizes.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Date of Birth - MM/DD/YYYY REQUIRED Please fill out this field. Please enter a date.
  
  Waiver for St Rose 5K
  Please enter me in the Saint Rose of 2022 Lima 5K.
  I agree to assume all responsibility for all risk of damage or injury to me as a participant in this event. In consideration of being accepted as an entrant in the Saint Rose of Lima 5K I hereby, for myself, my heirs, executors and administrators, release and discharge Saint Rose of Lima Parish, Central Mass Striders, and any and all other individuals, entities, and organizations associated with the race from all claims, damages, rights of action, present or future, whether the same be known, anticipated, or unanticipated resulting from or arising out of, or in incident to, my participation in the event. I hereby certify that I will not participate in Saint Rose of Lima 5K unless I am physically fit and sufficiently trained for competition in the race. I also grant permission for the use of my name and or picture in any broadcast, photograph or other account of this race. I understand that bicycles, skateboards, roller skates or blades, animals, and radio headsets are not allowed in the race and I abide by this guideline. I also agree that I will participate in the full distance of the race and will not take any deviation off the course. To do so could result in immediate disqualification if validated.
  
  I Agree Please select this field.
  
  Signature of Parent/Guardian - if participant is under age 18):
  
  Submit
  
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St. Rose of Lima

Northborough, MA

5K/Family Fun Registration