St. Patrick's Day Run Bloomington 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(s) *

$35.00 $30.00 + $2.80 SignUp Fee

(Group Pricing)

1 Mile Walk

$35.00 $30.00 + $2.80 SignUp Fee

(Group Pricing)

Would you like to join the following club: Lake Run Club?

As a club member, you will receive a $2.00 discount on event fees.

I want to join club “Lake Run Club”.

Waiver

In consideration of the foregoing, I for myself, my executors, administrators and assignees, do hereby release and discharge the Lake Run Club, VFW Post 454, and all other sponsors and supporters for all claims and damages, demands, actions, whatever in any manner arising or growing out of my participation in the St. Patrick's Day Run. I attest and verify that I have full knowledge of the risk involved in this event and I am physically fit and trained to participate in this event.

By checking this box, I agree to the waiver and that I am 18 or older, or that I have the authority to register these participants and agree to the waiver for them, and agree to the Privacy Policy.

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St. Patrick's Day Run Bloomington

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Would you like to join the following club: Lake Run Club?

Waiver

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Registrant #1

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Choose Your Event(s) *

Would you like to join the following club: Lake Run Club?

Waiver

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