43rd Annual Hawai'i Pacific Health Women's 10K & 5K Fun Run

SUNDAY, MAY 2 - SUNDAY, MAY 9, 2021

For more information, visit: www.HPHWomens10K.com

Want to know if you are already signed up? Check here: www.flpregister.com/464/search

PLEASE NOTE THIS IS A WOMEN’S ONLY RACE.
**Price is based on post marked date
** Mail in entry forms must be post marked by April 23, 2021

Entry Fee Per Person	Mar 10, 2021 - May 02, 2021
10K Virtual Run	$50.00
5K Virtual Run	$45.00
10K/5K Virtual HPH Employee	$35.00
10K/5K Virtual Active Military	$40.00
10K/5K Virtual Student	$40.00

Finisher Merchandise Pick-Up:

Location:

Boca Hawaii
330 Cooke Street, Honolulu, HI 96813
Phone: (808) 591-9839
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Dates/Times:

Friday, April 30, 2021; Noon – 6 p.m.

Saturday, May 1, 2021; Noon – 5 p.m.
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MAILING INFORMATION:

All finisher gear not picked up at the designated location will be mailed to the address provided during the registration process.
Please note merchandise will begin shipping to participants after the end of the race.

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Category

10K Virtual Run
Participants will receive a finisher shirt, bag and medal $50.00
5K Virtual Run
Participants will receive a finisher shirt, bag and medal $45.00
10K/5K Virtual HPH Employee $35.00
10K/5K Virtual Active Military
Active Military. Must present valid Military ID at Merchandise Pickup $40.00
10K/5K Virtual Student
High School, College or University Students. Must present valid Student ID at Merchandise Pickup $40.00

Team

Do you wish to create a new team, or join an existing team?

Create New Team
Join Existing Team

Participant Info

First Name

Last Name

Age on Race Day

Gender

Male Female

Employee Number

How did you hear about this race?

I understand that if a in-person event is not possible due to ongoing pendemic that the event will

How many years have you participated in this event?

Custom price category checkbox1

Custom price category checkbox2

Custom price category checkbox3

Custom price category checkbox4

Custom price category checkbox5

Custom price category checkbox6

Company Name (if participating in the Corporate Challenge):

Favorite song to run to? (Songs may be added as part of the Women’s 10K Spotify Playlist)

Contact Information

Address Line 1

Address Line 2

City

State/Province
Please use 2 letter abbreviation

ZIP or Postal Code

Country

Contact Info

Day Phone

Email Address

Email Address Confirmation

Emergency Contact Information

Emergency Contact Phone Number

Triathlon Relay Team

Team Info

Select or Create a Team

Team Name

Team Password

Team Password Confirmation

Select Number of Team Members

Division

Swimmer

Swimmer Name

Swimmer Age on Race Day

Swimmer T-Shirt Size

Swimmer USAT Number

Biker

Biker Name

Biker Age on Race Day

Biker T-shirt Size

Biker USAT Number

Runner

Runner Name

Runner Age on Race Day

Runner T-Shirt Size

Runner USAT Number

Optional extra donation to Hawai'i Pacific Health Women's Services

Extra Donation Amount
$

HPH Waiver

Website Women’s 10K Waiver:
I agree that, if the HPH Women’s 10K and 5K Fun Run must convert to a virtual event, my registration will automatically convert to a virtual race entry. In the event the race is transferred to a virtual event or cancelled, I acknowledge that no refunds or race registration transfers will be given.
In the event the Women’s 10K converts to a virtual run, I attest I have read and agree to abide by the rules of the virtual race scheduled for Sunday, May 2, 2021-Saturday, May 8, 2021. I will not participate in a virtual event unless I am medically able and properly trained and, by my signature, I certify that I am medically able to perform this event and I am in good health. I am aware of and assume all risks associated with running a virtual event on my own, including, but not limited to, falls, weather (heat and humidity), and traffic and road conditions, all such risks being known or unknown and appreciated by me when out running on my own without any type of support from local officials or event organizers. In consideration for acceptance of this entry, I, for myself and anyone entitled to act on my behalf, waive and release Hawai‘i Pacific Health and its affiliates, City and County of Honolulu, State of Hawai’i and representatives of this event from any and all injuries suffered by me. 
I give permission for free use of my name, voice or photo in any broadcast, telecast, advertisement or promotion of this event.

COVID-19:
I agree to follow the COVID-19 guidelines set by my county/state/country and follow social distancing guidelines. 

I AGREE that electronic submission of this application constitutes agreement to all the terms of this waiver and release statement.

I have read this agreement and fully understand its terms. I understand that I have given up substantial rights by signing it, and sign in it freely and voluntarily without any inducement.

Digital Signature of Participant (Type your full name here)

PARTICIPANTS UNDER THE AGE OF 18 ARE REQUIRED TO HAVE PARENT SIGN: This is to verify that I, as a parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releases, and, for myself, my heirs, assigns, and next of kin, release and agree to indemnity and hold harmless the Releases from any and all liabilities incident to my minor child's involvement of participation in the events as provided above, even if arising from their negligence.

Digital Signature of Parent Or Guardian (only required if the participant is under the age of 18)

Total Cost: (calculating...)

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