Rotary Club of Kernersville 4th of July 5K Run Online Registration

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Registrant #1

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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 *

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Phone *

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Street Address *

Country *

Zip Code *

City *

State *

Choose Your Event(s) *

5K Run/Walk

$30.00 + $3.25 SignUp Fee

(Group Pricing)

Kid's Fun Run/Walk

$15.00 + $3.25 SignUp Fee

(Group Pricing)

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Rotary Club of Kernersville 4th of July 5K Run

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Registrant #1

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Choose Your Event(s) *

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

Running Club Pricing

Corporate Pricing

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