5K and One Mile #Run4PeaceWalk4Hope

Who are you registering?

First name of person you are registering

Last name of person you are registering

Your first and last name if different from above

Phone Number

Email

Multi-line address

Country/Region

Address

City

Zip / Postal code

Who referred you, or how did you hear about this event?

School, Company, or Group Name (If applicable)

If ten or more participants from your group register, you may be eligible for a group prize after the results are tallied.

Department (If applicable)

What i s your race?

5K ($35.50) The only race and price option that includes a free T-shirt)

One Mile ($25.00)

Virtual One Mile ($10.00)

Virtual 5K ($12.50)

5K Student Discount $29.00 (12-18, and college students who scan their student ID's and email to admin@risingsouthliteracyschool.org)

5K Group of 10 runners: $300 (add $30 for each additional runner beyond the ten) T-shirt included.

5K -Children Under 12 - $5.00

One Mile - Children Under 12 - $5.00

Tee Shirt and Registration Bag

No Tee Shirt

Size Small $12.50 (Included with 5K)

Medium $12.50 (Included with 5K)

Large $12.50 (Included with 5K)

XL $12.50 (Included with 5K)

2X $13.50 (Included with 5K)

3X $14.50 (Only $5.00 if you purchase the 5K)

4X $15.50 (Only $5.00 if you purchase the 5K)

5X $15.50 (Only $5.00 if you purchase the 5K)

I am going to submit my payment by:

Cash App: $DedraMuhammad1919

PayPal: admin@risingsouthliteracyschool.org

Zelle: 256-694-3880

Credit Card (Once you click the "submit" button below, it will take you to the credit card option)

Other (Once you submit the form, you can email the admin about your payment).

Custom price (Enter the total amount you will be paying, i.e., just the 5K, and then proceed 2 the registration button. You'll be taken to a payment screen. If you are doing Zelle, Cash App, etc., you will see how to complete your transaction. Thank you!)

$

Participant Waiver –I acknowledge that running and walking events involve inherent risks, including but not limited to falls, weather conditions, traffic, and physical exertion. I certify that I am physically able to participate and assume all liability.

I acknowledge the liability statement that can be read in full on the website: www.risingsouthliteracyschool.org

Birthday

Month

Day

Year

5K and One Mile #Run4PeaceWalk4Hope

After April 25th, sign up only by clickng this link