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First name

Last name

Date of birth

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Phone

Street

City

State

Zip

Races

1 Mile Fun Run - Running - 1 Mile ($15.00)

5K Adult - Running - 5K ($30.00)

5K Student 17 and under - Running - 5K ($20.00)

Extras

Gender

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Female

Age on Race Day

Shirt Size

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M

L

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Team Name

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Fundraise for this event

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Goal