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Race for Justice Runner Sign-Up

 

 Online registration for the PHC/IJM 5K event will be available until Friday, April 25, 2014, at 5:00pm EST.  Walk-in registration will be available on race day at Franklin Park.

Each participant must download, print, fill-out and bring this waiver on race day.  Runners who do not check in and submit a signed waiver may not run in the race. If you chose to be sponsored, you may not run unless your sponsor has submitted payment under the "donor" link and listed your name.

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* First Name:
* Last Name:
* Address:
* City:
* State:
* Zip:
* Phone Number:
Alt. Phone (i.e., cell):
* Email Address:
* # of PHC students registering ($15 ea):
* # of individuals (non-PHC students) registering ($25 ea):
* # of families registering ($50 ea - list all names in Comments box):
* Are you a sponsored runner? (Checking here does not complete your registration; your sponsor must make payment under the donor page and list your name.)
Yes
No
Dollar amount of additional donations:
T-shirt sizes (S, M, L, XL) If you are submitting your registration after April 5, 2014, at 5:00pm EST, T-shirts are not guaranteed
* Birthdate:
* Emergency contact name:
* Emergency contact phone # (enter number without dashes or spaces):
Comments:



* required