Gladys L. Benerd Memorial 5K Registration

Saturday, November 23, 2024
8:30 a.m. - 12:00 p.m.

Full Name of Registrant *

Email *

Phone Number *

Date of Birth * +

Shirt Size *

Please complete and submit this liability waiver *

Will you have a runner participating in the 100 yard dash? (age 10 and under) *

Yes

No

How many runners (10 and under) will be participating in the 100 yard dash? *

Please complete and submit this liability waiver for all 100 yard dash participants *

The registration fee for this event is $30 for General Public and $20 for Pacific Students. After completing this form you will be directed to a payment screen. Registration is NOT COMPLETE until fee is paid and waivers are received. *

I understand