One Voice Georgia for Disability Rights Registration Step 1 of 6 16% Name* First Last Email* Enter Email Confirm Email Cell Phone NumberAddress needed to receive a t-shirt Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code T-Shirt Size* Adult Small Adult Medium Adult Large Adult X-Large Adult XX-Large Adult XXX-Large I do not want the T-Shirt Participant Waiver for Race Registration* Select All I assume all such risks being known, appreciated, and accepted by me. I grant permission to use my photographs, motion pictures, recordings or any other record of this event for any legitimate purposes. I know that running a road race is a potentially hazardous activity if I have not properly trained. I will not enter and participate unless I am medically able and properly trained, and by checking in agreement, I certify that I am medically able to perform this event, and am in good health, and I am properly trained. I assume all risks associated with participating in this event, including but no limited to: falls, physical contact with other participants, volunteers, race personnel, contract service providers, employees, and spectators including the potential the contraction of a communicable disease resulting from contact with other participants, volunteers, race personnel, contract service providers, employees, and spectators. I assume all risks including: the effects of the weather; high heat and/or humidity; traffic and the conditions of the road including surrounding terrain. I further agree to abide by the Center for Disease Control’s (CDC) recommendations for the prevention of the spread of the 2019 Novel Coronavirus Disease (COVID-19) and other communicable diseases, and I attest to having read the CDC’s guidance at: https://www.cdc.gov/coronavirus/2019-ncov/prepare/prevention.html. I assume all such risks being known, appreciated, and accepted by me. I grant permission to all of the foregoing to use my photographs, motion pictures, recordings or any other record of this event for any legitimate purposes. I understand that this event does not provide for refunds in the event of a cancellation, and by agreeing to this waiver, I consent that I am not entitled to a refund if the event is cancelled before or during the event.I would like to enter second registration for our family/group* Yes No, skip pages 2, 3, & 4 Name - Second Registration First Last Email - Second Registration Enter Email Confirm Email Cell Phone Number - Second RegistrationSecond Registration - Address needed to receive a t-shirt Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code T-Shirt Size - Second Registration Adult Small Adult Medium Adult Large Adult X-Large Adult XX-Large Adult XXX-Large It's pretty, but I do not want the T-Shirt 2nd Participant Waiver for Race Registration* Select All I assume all such risks being known, appreciated, and accepted by me. I grant permission to use my photographs, motion pictures, recordings or any other record of this event for any legitimate purposes. I know that running a road race is a potentially hazardous activity if I have not properly trained. I will not enter and participate unless I am medically able and properly trained, and by checking in agreement, I certify that I am medically able to perform this event, and am in good health, and I am properly trained. I assume all risks associated with participating in this event, including but no limited to: falls, physical contact with other participants, volunteers, race personnel, contract service providers, employees, and spectators including the potential the contraction of a communicable disease resulting from contact with other participants, volunteers, race personnel, contract service providers, employees, and spectators. I assume all risks including: the effects of the weather; high heat and/or humidity; traffic and the conditions of the road including surrounding terrain. I further agree to abide by the Center for Disease Control’s (CDC) recommendations for the prevention of the spread of the 2019 Novel Coronavirus Disease (COVID-19) and other communicable diseases, and I attest to having read the CDC’s guidance at: https://www.cdc.gov/coronavirus/2019-ncov/prepare/prevention.html. I assume all such risks being known, appreciated, and accepted by me. I grant permission to all of the foregoing to use my photographs, motion pictures, recordings or any other record of this event for any legitimate purposes. I understand that this event does not provide for refunds in the event of a cancellation, and by agreeing to this waiver, I consent that I am not entitled to a refund if the event is cancelled before or during the event.I would like to enter third registration for our family/group Yes No, skip pages 3 & 4 Name - Third Registration, for family/group participation First Last Email - Third Registration Enter Email Confirm Email Cell Phone Number - Third RegistrationThird Registration - Address needed to receive a t-shirt Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code T-Shirt Size - Third Registration Adult Small Adult Medium Adult Large Adult X-Large Adult XX-Large Adult XXX-Large It's pretty, but I do not want the T-Shirt 3rd Participant Waiver for Race Registration* Select All I assume all such risks being known, appreciated, and accepted by me. I grant permission to use my photographs, motion pictures, recordings or any other record of this event for any legitimate purposes. I know that running a road race is a potentially hazardous activity if I have not properly trained. I will not enter and participate unless I am medically able and properly trained, and by checking in agreement, I certify that I am medically able to perform this event, and am in good health, and I am properly trained. I assume all risks associated with participating in this event, including but no limited to: falls, physical contact with other participants, volunteers, race personnel, contract service providers, employees, and spectators including the potential the contraction of a communicable disease resulting from contact with other participants, volunteers, race personnel, contract service providers, employees, and spectators. I assume all risks including: the effects of the weather; high heat and/or humidity; traffic and the conditions of the road including surrounding terrain. I further agree to abide by the Center for Disease Control’s (CDC) recommendations for the prevention of the spread of the 2019 Novel Coronavirus Disease (COVID-19) and other communicable diseases, and I attest to having read the CDC’s guidance at: https://www.cdc.gov/coronavirus/2019-ncov/prepare/prevention.html. I assume all such risks being known, appreciated, and accepted by me. I grant permission to all of the foregoing to use my photographs, motion pictures, recordings or any other record of this event for any legitimate purposes. I understand that this event does not provide for refunds in the event of a cancellation, and by agreeing to this waiver, I consent that I am not entitled to a refund if the event is cancelled before or during the event.I would like to enter forth registration for our family/group* Yes No, skip page 4 Name - Forth Registration, for group participation First Last Email - Forth Registration Enter Email Confirm Email Cell Phone Number - Forth RegistrationForth Registration - Address needed to receive a t-shirt Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code T-Shirt Size - Forth Registration Adult Small Adult Medium Adult Large Adult X-Large Adult XX-Large Adult XXX-Large It's pretty, but I do not want the T-Shirt 4th Participant Waiver for Race Registration* Select All I assume all such risks being known, appreciated, and accepted by me. I grant permission to use my photographs, motion pictures, recordings or any other record of this event for any legitimate purposes. I know that running a road race is a potentially hazardous activity if I have not properly trained. I will not enter and participate unless I am medically able and properly trained, and by checking in agreement, I certify that I am medically able to perform this event, and am in good health, and I am properly trained. I assume all risks associated with participating in this event, including but no limited to: falls, physical contact with other participants, volunteers, race personnel, contract service providers, employees, and spectators including the potential the contraction of a communicable disease resulting from contact with other participants, volunteers, race personnel, contract service providers, employees, and spectators. I assume all risks including: the effects of the weather; high heat and/or humidity; traffic and the conditions of the road including surrounding terrain. I further agree to abide by the Center for Disease Control’s (CDC) recommendations for the prevention of the spread of the 2019 Novel Coronavirus Disease (COVID-19) and other communicable diseases, and I attest to having read the CDC’s guidance at: https://www.cdc.gov/coronavirus/2019-ncov/prepare/prevention.html. I assume all such risks being known, appreciated, and accepted by me. I grant permission to all of the foregoing to use my photographs, motion pictures, recordings or any other record of this event for any legitimate purposes. I understand that this event does not provide for refunds in the event of a cancellation, and by agreeing to this waiver, I consent that I am not entitled to a refund if the event is cancelled before or during the event. IMPORTANT!! I am participating in support of:*The Arc GeorgiaThe Arc MaconThe Arc of Southwest GeorgiaThe Arc of Thomas GradyThe Arc of Douglas CountyThe Arc of Clayton CountyThe Arc of Northwest GeorgiaOtherWe want your registration(s) and donation to go to the chapter of your choice. Please take a minute to check the chapter you want to support.If other, please indicate: One Voice Georgia Registration(s). Check the number of registrations (1, 2, 3 or 4) you entered above:*1 Registration2 Registrations3 Registrations4 Registrations*Note: For approved registrations only. Confirmation by the race director required.I would like to make an additional donation to support People with Disabilities affected by COVID-19Donation of $250Donation of $100Donation of $75Donation of $50Donation of $25If you have a coupon code, enter it here: Total $0.00 Payment Method*Credit CardPayPal CheckoutCredit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Expiration Date Security Code Cardholder Name CAPTCHA
