REGISTRATION FORM

> ALL FIELDS REQUIRED <

Before filling out this form, please paste the "case sensitive" confirmation code, you got from the race organizer, this is a ONE TIME use code. Don't know how to get one, please scroll up to read instructions above!

Verify Code

Valid Code!

Wrong or Expired Code!

Verified

After you hit "verify code" and the box turns green, please continue below:

Event Preference click on box below to see options
—Please choose an option—5K10K

Your First Name

Your Last Name

Gender
FemaleMale

Age at date of event on Sept 01st.

Category
—Please choose an option—Open55+

Unisex T-shirt Dryfit
—Please choose an option—SmallMediumLargeExtra Large

Club/Group/Team you're representing

Location where you are participating from representing your area

Your Telephone Number

Your Email Address must be valid and can accept emails and your mailbox not full

Confirm Your Email Address make sure it's identical, check for capital letters and spelling

ACKNOWLEDGEMENTS
I acknowledge I am physically capable in participating in this event. I understand that my entry fee is non-refundable and also non-transferable and that the race is chip-timed and if I fail to return the timing chip, I will be charged a $100 replacement fee.

_________________
NOTE:
- After clicking the button below, you will get a popup message stating your registration was sent and will be redirected to a new page. If these does not happen, please verify all the information is inputted in the form.

- Also, you should receive an automatic email confirmation, please check your junk/spam folder or promotions tab if you do not see it in your inbox. Also, note that Hotmail, Live, iCloud may block this email.

Please review your information entered above We're not making any edits to your submitted data.
I've verified my information above and it's correct.

Δ