Online Pre-Registration
Individual 5K Pre-Registration
First Name
*
Last Name*
Address
*
City
*
State*
Zip*
Telephone
*
E-mail*
5K
*
----
Run
Walk
Age*
Gender*
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Female
Male
T-Shirt Size
*
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Adult Small
Adult Medium
Adult Large
Adult XL
Adult 2XL
Adult 3XL
Registration Fees
*
$30 (Submitted by Nov. 13, 2011)
I will commit to soliciting $60 or more in pledges
Discount Code
* Individual Registration fee will be waived for individuals with $60 or more in pledges. Sponsor forms and all pre-paid pledges must be submitted by Monday, November 14, 2011. Race Day 5K Individual Registration is $40. All registered participants will recieve official t-shirt and goodie bag.
** All participants are required to sign a Waiver of Liability, Assumption of Risk, and Indemnity Agreement. This will be available at the Check-In/Registration booths on Race Day.
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