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New Registration
Credit Card Payment Accepted Only Through Paypal, no account is required
Registrations are $25 per Person
Family registrations
(related persons only)
are $50 for first two people and $10 for each additional person.
Registration gets you ONE included 50/50 blend t-shirt
XXL shirts are $2 extra
Online Registration includes a $0.50 Per-Person processing fee
New Registration
First Name
Middle Initial
Last Name
What is a good contact phone number for the participant?
Phone Number
What is the participants address? (Please put unit numbers on the second line!)
Address
What is the participants mailing zipcode?
Zipcode
How old is the participant right now?
Age
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Is the participant male or female?
Gender
Female
Male
How will this person participate?
Entry Type
Walker
Runner
Volunteer
Honorary Donation
Is the participant a breast cancer survivor?
Survivor?
No
Yes
Would the participant like to be on the RABC Board or 5K Commitee?
Board Interest?
No
Yes
What size shirt would the participant like?
Shirt Size
No Shirt (Donate Cost to Project)
Child's Small
Child's Medium
Adult Small
Adult Medium
Adult Large
Adult X-Large
Adult XX-Large ($2.00 Surcharge)
Dri-Fit Child's Small ($5.00 Surcharge)
Dri-Fit Child's Medium ($5.00 Surcharge)
Dri-Fit Women's Small ($5.00 Surcharge)
Dri-Fit Women's Medium ($5.00 Surcharge)
Dri-Fit Women's Large ($5.00 Surcharge)
Dri-Fit Men's Medium ($5.00 Surcharge)
Dri-Fit Men's Large ($5.00 Surcharge)
Dri-Fit Men's X-Large ($5.00 Surcharge)
Would you like to make an additional donation with your registration?
Donation $
Anything else we should know?
Comments?
Please type these words so we can be sure you're a human!
Captcha
Please review this agreement...
Waiver Statement
As an entrant in the Race Against Breast Cancer, I assume complete responsibility for injury to me or damage to property which may occur during the event or while I am on the premises of the event. I hereby release and hold harmless the sponsor, promoters, and all other persons associated with the event from any and all liability for injury or damage, whether caused by negligence of the sponsors, promoters or other persons associated with this event or otherwise. I grant permission for any and all of the foregoing to use any photographs, video tapes, motion pictures, recordings or any other record of this event for any purpose whatsoever. I understand that my rental chip must be returned within seven days of the event or I will be assessed the $30.00 purchase price. By clicking the "I AGREE" button below I agree to the above statement and enter into a legally binding agreement as certified by my identifying information typed above.
I AGREE
