"*" indicates required fields Runner InfoRunner Name* Runner First Name Runner Last Name Gender*MaleFemaleDate of Birth* MM slash DD slash YYYY School Grade If in school*Grade in FallN/A1st2nd3rd4th5th6th7th8th9th10th11th12thNot in School Running as Adult?* Yes Shirt sizeShirt sizeYouth SmallYouth MediumYouth LargeYouth Extra LargeAdult SmallAdult MediumAdult LargeAdult Extra LargeAdult 2XLAdult 3XLAdult 4XLRunning both races Tots/Trots Yes Veteran Yes Parents/Guardians Names*NamePhone NumberEmail Add RemoveAddress* Street Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Participant/Parent/Guardian Waiver:*I hereby state that I am physically able to participate and assume all risks; (for example but not limited to, injuries associated with long-distance running on surface streets; dehydration, pulled muscles, and joint sprains, etc...) associated with this event. I, myself, heirs, and assignees, hereby release Church180, all sponsors, coordinating groups, and any individuals associated with this event and their representatives from any and all claims that may arise as a result of my participation in the Church180 5K Turkey Trot. I agree to above Waiver Donate? Yes Donation Amount Processing Fee Price: $0.00 Total Credit Card*Card Details Cardholder Name NameThis field is for validation purposes and should be left unchanged.
