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Honor Run 5k Registration Form
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Price Schedule
Through
09/07/2024
Final
Adult
$30
13 and Under
$10
Categories
*
Adult
CLOSED
13 and Under
- $10.00
Participant Information
Contact Email
*
Participant First Name
*
Participant Last Name
*
Participant Birthdate
*
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Participant Gender
*
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Street Address (w/Apt#)
*
City
*
State
*
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-- select state --
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Col.
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
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Montana
Nebraska
Nevada
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New Jersey
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New York
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Ohio
Oklahoma
Oregon
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Zip Code
*
Phone
*
Would you like to
receive important event text alerts
on this number (eg. changes or delays)?
Emergency Contact Name
*
Emergency Phone
*
How did you hear about our event?
-- select one --
Social Media
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Run Club
Make a Donation
Back The Blue NC
click here
, to learn more about this cause
Amount $
A non profit organization dedicated to supporting the children and families of North Carolina's fallen law enforcement officers.
Waiver
*
I have read and agreed to the TERMS
*
CLICK HERE TO VIEW THE TERMS
.
Is the participant 18 or older?
*
18 or older
Under 18
Parent or Legal Guardian’s Signature - By providing your electronic signature you agree that you have the authority to register these participants and agree to the waiver(s) for them as their parent or legal guardian.
If registering a child under 18, you are consenting to the collection of the child's information that you are providing for the purposes of registration.
Parent's signature
Payment Details
Discount or Tracking Code
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Do not COPY & PASTE the code, please type it into this field.
Price
$
Discount (-)
$
Total
no handling
$
Handling
$
Donation
$
Total Owed
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Payment Method
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Address:
click the "submit" button to submit your order then send a check to (or pay in person at) the address above.
1. Venmo the total amount to the Phone #:
2. Make sure you enter the code,
58784
in "What's it for".
3. Click the "pay now" button.
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