Kia’s Spring into Wellness 5K Online Registration

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Registrant #1

Who are you registering? *

First Name *

Last Name *

Email Address *

Confirm Email *

Create Password *

This will be the password for your RunSignup account.

Confirm Password *

Date of Birth *

Format: mm/dd/yyyy

Used for age group calculations

Gender *

Male Female

Phone *

Valid formats include: 000-000-0000 or 0000000000

Street Address *

Country *

Zip Code *

City *

State *

Choose Your Event *

5K Walk/Run

$20.00 + $3.00 SignUp Fee

(Group Pricing)

1 Mile Walk/Run

$20.00 + $3.00 SignUp Fee

(Group Pricing)

Tot Trot

Open to ages 5 and under.

$20.00 + $3.00 SignUp Fee

(Group Pricing)

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Kia’s Spring into Wellness 5K

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