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Online Registration
      

6th Annual Race to Beat Breast Cancer

   

6th Annual
Race to Beat Breast Cancer
5K and 10K
Hosted by Harrisonburg Parks and Recreation.
Saturday October 25, 2008


(All proceeds go to RMH Breast Cancer treatment)
 

Entry Fee:

Early Registration ends on October 17, 2008. Fee of $15
Late Registration/ Race Day Registration: $20
*$10 per person for special groups/teams, i.e. clubs, sports, fraternities, sororities, etc.*
 

Please Enter Participants Information and click below to proceed to a secure credit card processing page. To register more than one participant select the "Add Additional Registration" option after submitting each registration or just click on the "Back Button" in Your Browser to return to this page.

Please notify garysmith@runwalkjog.com if you experience problems with online registration.  For online registration a processing fee of $1.50 will be added to the registration fee. For group registration this fee is $1.00 per person.

  

5th Annual Race to Beat Breast Cancer
 
           Last Name:


           First Name:


                Address:


                       City:


                     State:


                         Zip:


     Daytime Phone:


      Evening Phone:


                     Email:


                        Age:


                          Sex:


                       Event:

                            Select Category
                                 Runner
                                 Walker


                     T Shirt:

           

Select Category (You must have a minimum of 5 participants for group discounts)


                                 Individual $15.00


                                 Team Group, i.e. clubs, sports, fraternities, sororities, etc. $10 per person (minimum of 5 per team)

(Required For Group Discount)
Team Group Name: (Individual Registration Leave Blank)


Waiver: I hereby release the City of Harrisonburg, its employees, and volunteers from all claims for damages arising from any accidents or injury, which are caused by or arise from the participation of the above name applicant during any program or in any facility or at any location where this program is held.
 

              Waiver:   You Must Agree With Waiver In Order To Participate.


 Signature (Required For All Participants):        

Signature above must be signed by parent or guardian if under 18



 
   
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