info@22saveshockey.com

5K Registration Form

Name *

First

Last

Email *

Phone *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Gender

Male
Female

Age (on Nov 13, 2021) *

Shirt Size *

Live or Virtual Event *

In Person 5K Run - $30.00
Virtual 5K Run - $25.00

Total Amount

$0.00

Waiver of Liability

Acknowledgement *

By checking this box, I agree to the waiver of liability and certify that I am 18 years of age or older