Offline Registration

Online registration is closed. Please print this page, fill in and bring to the registration table on the race date - November 4th.

5k race registration is $30

Email:

First Name:

Last Name:

Gender:

Male

Female

You can run as a part of a team. Coworkers, schoolmates, families or anybody else can form a team!

Team Name:

(T-shirts are available while supplies last)

T-Shirt Size:

Small

Medium

Large

X-Large

USATF Number:

Phone Number:

Address:

City:

State:

Zip Code:

Age on Event Day:

Waiver: By submitting this form, I acknowledge that participation in the Legwork for Lungs 5k and Mile Walk involves a risk of injury, including bodily injury, and assume the risk for same. On my own behalf and on behalf of my heirs and legal representatives and to the fullest extent permitted by law, I hereby release and discharge the Legwork for Lung Team and its affiliates, sponsors, agents, Bernards Township, and any other company/organization contributing to this event and representatives, of and from any and all liability for injury, death, or damages and/or any other claims, demands, losses or damages, incurred by me in connection with any aspect of the 5k run and walk. I hereby grant full permission to use any photographs or any other record of this event for legitimate purposes.

Signature: