5:00AM October 21, 2023 at

Rizal Ave., Brgy. Lourdes, Bamban, Tarlac

REGISTRATION FORM

Fun Run Rate

____ 3K- P400 ____ 5K- P500

NAME: AGE: SEX:

CONTACT NUMBER: EMAIL ADDRESS:

GROUP/ INSTITUTION: REGISTRATION FEE INCLUDES: (Race

________ PNP- _______________ Singlet and Bib Number)
________ Municipality of Bamban, Tarlac ______ XS _______ L
________ Barangay Council ___________________ ______ S _______ XL
________ Others: _________________ ______ M _______ XXL

RACE WAIVER

I, _________________________________ hereby certify that I am in good health, and I have trained to run the
distance of the race that I am entering. I know all the risks associated with participating in this long running event.
Furthermore, I waive and release the organizers and sponsors of this event and their offices from all claims and
liabilities that may arise out of accident, negligence on the part of the entities named in this waiver. I grant
permission to all of the foregoing to use my photos, videos or any other recording of this event for legitimate
purpose.

_____________________________________
Signature over printed Name of Participants

Below 16 years old: (Name and Signature of parent/ Guardian)

_____________________________________
Signature over printed name of Parent/ Guardian

Designated Registration Centers

 Bamban Police Station, Brgy. Anupul, Bamban, Tarlac
 Bamban Tourism Office

For more Info contact:

 Ms. Cherrylyn M. Pascua – 0933-864-8874
 Ms. Patrizia Josephine Santos -0906-360-5225