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This event will be held on Saturday, September 9th starting at 9AM at Friendship Park. NO entry fee. For more information, call 608-339-4342 or go to bit.ly/3z5CCrF.

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* 1. Participant's contact information:

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* 2. I am 18 years or older

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* 3. Please enter the first and last name(s) of others that you are also registering for (*Please note, only parents/guardians can register those under age 18*):

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* 4. I/We plan to participate in the (*Please note, the Run, Walk and Bicycle Ride are occurring at the same time, participants can choose what event to participate in):

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* 5. How did you hear about this event?

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* 6. I grant permission to Adams County and their agents or employees, to use my name and photographs taken of me (and participants under the age of 18 of which I am their parent/guardian) in conjunction with its Suicide Prevention Walk, Run & Bicycle Ride on September 9, 2023, for publication on the Adams County Health & Human Services- Division of Public Health Facebook page and in publications such as brochures and newsletters. I hereby waive any right to inspect or approve the finished photographs or printed or electronic matter that may be used in conjunction with them now or in the future, whether that use is known to me or unknown, and I waive the right to royalties or other compensation arising from or related to the use of the photograph. I am 18 years of age or older, or have had my parent or guardian electronically sign, and I am competent to contract in my own name. I have read this release and I fully understand the contents, meaning and impact of this release. I understand that I am free to address any specific questions regarding this release by submitting those questions in writing prior to electronically signing, and I agree that my failure to do so will be interpreted as a free and knowledgeable acceptance of the terms of this release.

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* 7. I understand that participation in the 2023 Adams County Suicide Prevention Run, Walk & Bicycle Ride involves activities that may be hazardous. Participants therefore agree to expressly assume any inherent risk or injury or harm and hereby release Adams County from any/all liability for injury, illness, death and/or property damage that may result due to participant(s)' involvement in this event. (*Please note, bicycle helmets are REQUIRED for all ages if participating in that event*). I acknowledge that I have read, understand and agree to this Release of Liability and Assumption of Risk for myself and all participants I am registering that are under the age of 18 and of which I am their parent/guardian.

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* 8. DO NOT COMPLETE THIS QUESTION IF IT IS AFTER 8/18. Final t-shirt orders were due 8/18. 

Would you like to purchase a t-shirt? T-shirts are $15. Please select what size(s) you want to purchase.

Before clicking "done" to submit your registration, open the online payment method (click here) to complete the payment. You will not be automatically directed to the payment system.

For "Payment Type" select either option and put "Suicide Prevention" in the "Invoice #/ Case #" section. (If you order more than 1 t-shirt, multiply number ordered by 15 to get your payment amount. There is a small service fee- $1 or 2.95%, whichever is greater, that will be applied when checking out).

Payment must be received by 8/18 to guarantee your t-shirt order ($15/shirt, all proceeds go to suicide prevention/mental health activities in Adams County).

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Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult XL
Adult 2XL
Adult 3XL
Adult 4XL

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