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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
*
S
M
L
XL
2XL
3XL
Youth S
Youth M
Youth L
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
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