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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 ($25.00)

5K - Running - 5K ($35.00)

Extras

XXL Shirt - $5.00

XXXL - $5.00

Gender

Male

Female

Shirt (Larger Sizes are additions see extras)

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Fundraise for this event

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Team

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Set a fundraising goal

Goal

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