Online Registration

12k's of Christmas Charity Run

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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 garydsmith@runwalkjog.com if you experience problems with online registration.  A $2.25 processing fee will be added for online registration. 
                                  
12k's of Christmas Charity Run
      
             Last Name:


             First Name:


                  Address:


                        City:


                       State:


                           Zip:


                     Gender:


               Birth Date:


  Age On Event Day:


                       Phone:


                        Email:


                         Event:       


                   Shirt Size:

LIABILITY WAIVER:

Waiver: In consideration of this entry acceptance, I hereby for myself, my heirs, executors and administrators, waive any and all rights and claims to damages I may have against the Brandon Educational Scholastic Team, and any other individuals or entities connected with the sponsoring or organizing of this event, and for any injuries, loss or death sustained by me. I am in good physical condition for this event.

  
                                          Waiver:


                                      Signature:


Parent Or Guardian If Under 18:

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