Online Registration

AUTISM AWARENESS RIVERHAWK 5K & KIDS FUN RUN

  

Benefiting the autism program at Belmont Ridge Middle School & Organization for Autism Research

RACE DAY- Sunday, April, 29th 2012

Belmont Ridge Middle School
19045 Upper Belmont Place Leesburg, VA 20176

Registration begins at 7:00am April 29th (waiver signed at registration table)

Online Registration Is Now Closed
    
5k Race( 3.1 miles)- Entry fee is $10.00 for all participants 8 years of age and above

All Belmont Ridge students/staff are $5.00

Kids Fun Run (1 lap around the Belmont Ridge track)- FREE (8 years and under)

      
                  

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 $1.00 processing fee will be added for online registration. 

                                  
RIVERHAWK 5K
      
             Last Name:


             First Name:


                  Address:


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                    Gender:


               Birth Date:


  Age On Event Day:


                       Phone:


                        Email:


                        Event:  


                     
Participant Signature:


Parent Or Guardian If Under 18:

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.

Online Registration Is Now Closed

  

   
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