Around the Park for Autism 5K Online Registration

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Registrant #1

Who are you registering? *

Myself 18+

Friend 18+

Minor Under 18

By selecting this box, you are indicating that you are the parent/guardian of the person you are about to register. Additionally, if the child is under the age of 13, you are consenting to the collection and use of the information about the child for the purpose of the registration as described in our privacy policy.

Basic Info

First Name *

Last Name *

E-mail Address *

Confirm E-mail *

Password *

To be able to access / edit your registration.

Confirm Password *

Additional Information

Date of Birth *

Format: mm/dd/yyyy

Used for age group calculations

Gender * Male Female

Phone *

Format: ###-###-####

Address

Street Address *

Country

Zip Code *

City *

State *

Choose Your Event(s) *

Around the Park for Autism 5K Run $20.00 + $2.50 SignUp Fee ? (Group Pricing)
Around the Park for Autism 5K Walk $20.00 + $2.50 SignUp Fee ? (Group Pricing)

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