Walk Around the Block for Autism Online Registration

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 Run/Walk

$25.00 + $2.50 SignUp Fee

— Group/Team Pricing May Apply (Group Pricing)

Kids Fun Run/Walk

$11.00 + $1.66 SignUp Fee

— Group/Team Pricing May Apply (Group Pricing)

Mile Fun Run/Walk

$25.00 + $2.50 SignUp Fee

— Group/Team Pricing May Apply (Group Pricing)

Virtual Walk/Run

$25.00 + $2.50 SignUp Fee

(Group Pricing)

Vendor Section

$50.00 + $4.00 SignUp Fee

(Group Pricing)

Would you like to join or create a Group/Team?

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Walk Around the Block for Autism

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Team Pricing

Corporate Team Pricing

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Registrant #1

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Would you like to join or create a Group/Team?

Team Pricing

Corporate Team Pricing

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