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Price Schedule

	thru 08/09/2018	final	final
5K - Competitive 5K (official results)	$25.00	$30.00
WA - Recreational 5K (no official results)	$25.00	$30.00
MI - Mile	$25.00		$30.00

Categories*

5K - Competitive 5K (official results) - $25.00

WA - Recreational 5K (no official results) - $25.00

MI - Mile - $25.00

Participant Information

Email *

Participant First Name *

Participant Last Name *

Participant Birthdate *

Participant Gender *

Male

Female

Country Address

Street Address *

City *

State *

Zip Code *

Phone *

Emergency Contact Name *

Emergency Phone *

T-Shirt Size *

Shirt sizes are guaranteed to all those registered on or before August 9.

Make a Donation

Would you like to make a tax-deductible donation to the Tri-Area Ministry Food Pantry?

Donation $

Would you like to make a tax-deductible donation to ChurchNet?

Donation $

Waiver

I have read and agreed to the waiver*

Are you 18 or older?*

18 or older Under 18

Payment Summary

Price

Donation

Handling

Total

Payment Information

Cardholder First Name

Cardholder Last Name

Cardholder Address

Cardholder Country

City, State, Zipcode

Credit Card #

Exp. Date /

CVV Code

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