2017 Firehouse 5K Run Registration Form


The 2017 Firehouse 5K started at 8:00am at the Stony Point Ruritan Club (2835 Watts Passage, Charlottesville, VA 22911). The race route started at the club, down Watts Passage to Watts Station Drive, then a quick turn around and back to the Ruritan club. There WAS a firetruck to climb on!!


First Name:

Last Name:

Age on Race Day:






5 Digit ZIP Code:


Phone No. (xxx-yyy-zzzz)

E-mail Address:

Tee Shirt (included in registration fee) Size:


Are you a military veteran, a first responder or an active duty member of the armed forces or the police?
Your cost is $15. A member of the public is asked to pay $25.

EVENT DISCLAIMER - Please review the following waiver and disclaimers. None of this information is shared with anyone. By clicking "REGISTER", you accept this waiver and these disclaimers.

Waiver and Release: By participating in this Event, I do so at my own risk. I assume all risk of injury, illness, damage or loss to me or my property that might result, including without limitation, any loss or theft of personal property. I consent to medical treatment in the event of injury, accident and/or illness during the Event. I agree on behalf of myself (and my personal representatives, heirs, executors, administrators, agents and assigns) to release and discharge the organizers of this event, its principals, its officers & directors, its employees, all sponsors and their representatives and employees from any and all claims or causes of action (known or unknown) arising out of their negligence. I acknowledge that I have carefully read this ‘Waiver and Release’ and fully understand that it is a release of liability. By clicking on 'REGISTER' above, I am waiving any right that I may have to bring legal action to assert a claim against any and all Event sponsors for their negligence. I hereby grant full permission to any and all of the foregoing to use my name and likeness in any broadcast, telecast, video or print media reporting or advertising of the Event without compensation.