Indian Run Registration Form - Event Date October 4, 2025

Indian Run

Hosted by Historic Pocahontas, Inc.
40th Annual Indian Run

OCTOBER 4, 2025

  LOCATION: Pocahontas, VA (124 E Water Street)

ONSITE REGISTRATION: 8:00 AM to 8:45 AM

RACE START: 9:00 AM (youth events at 10:30)

If you experience any issues completing and submitting this form, please email us at historicpocahontas@gmail.com

PRE-REGISTRATION FEE: (ends August 22)

$20 : 8K Run/5K Run/5K Walk

$10 : Youth Events

(Papoose 2- 5 yrs & Brave Run 6-10 yrs)

$5 Each additional sibling

AFTER August 22:

$25 : 8K Run/5K Run/5K Walk

$15 : Youth Events

(Papoose 2- 5 yrs & Brave Run 6-10 yrs)

$5 Each additional sibling

NOTE: For guaranteed T-shirt register by August 22. All others 1st come 1st serve.

Like and follow Indian Run on Facebook to stay updated
Participant Details - All 8k and 5k participants must register separately
IF REGISTERING FOR YOUTH EVENTS, PLEASE COMPLETE CONTACT INFORMATION FOR PARENT/LEGAL GUARDIAN THEN FILL IN YOUTH NAME, AGE, AND T-SHIRT SIZE IN APPROPRIATE SECTION BELOW.
Full Name*

First NameLast Name
Age as of October 1, 2025*
Date of Birth

MonthDayYear
Date
Please Select*
Email
example@example.com
Phone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact Person*

First NameLast Name
Emergency Person Phone Number*

Area CodePhone Number
Relationship to Emergency Contact Person*
IF REGISTERING FOR YOUTH EVENTS, FILL IN PARTICIPATE NAME AND AGE BELOW:
Youth Name Youth Age
Youth Name Youth Age
Youth Name Youth Age
Youth Name Youth Age
Request T-shirt Size (not guaranteed after August 22)

Adult SAdult MAdult LAdult XLYouth SYouth MYouth L
If registering more than one youth, select t-shirt size for 2nd youth below (not guaranteed after August 31)

Youth SYouth MYouth L
If registering more than one youth, select t-shirt size for 3rd youth below (not guaranteed after August 31)

Youth SYouth MYouth L
Registration Payments
Payment Method*
Waiver & Release
I confirm that I am in good shape, health, and condition.I don't have any medical condition or medical history that will affect my participation in this event.I will follow the rule and regulations of the road race event.I acknowledge that this road race requires physical activity and there are possible risks and danger.I release the road race event organizers for any responsibility in case of an accident, illness, or injury.I allow my photo to be taken during the event and used for event advertising and marketing.I confirm that all information in this registration form is accurate and true.
Date Signed*

MonthDayYear
Date
Signature*

My Products

8K run$20.00

pre-register by Aug 22 2025

5K run$20.00

pre-register by Aug 22 2025

5K walk$20.00

pre-register by Aug 22 2025

Youth - Papoose Run 2 -5 yrs$10.00

pre-register by Aug 22 2025

Youth - Brave Run 6 - 10 yrs$10.00

pre-register by Aug 22 2025

Additional Sibling - Papoose Run 2 - 5 yrs$5.00

select quantity below

Quantity

Additional Sibling - Brave Run 6 - 10 yrs$5.00

select quantity below

Quantity

Total $0.00

Credit Card

Should be Empty:

Indian Run

Participant Details - All 8k and 5k participants must register separately

Registration Payments

Waiver & Release

Credit Card