Road Race Online Registration
Race Info
10K Road Race  
  Entry Fee $40.00  
5K Road Race:  
  Entry Fee $35.00  
Fun Walk  
  Entry Fee $30.00  
Additional T-Shirts:  
  All Sizes $10.00  
Youth:  
Small:  
Medium:  
Large:  
X-Large:  
XX-Large:  
Additional Spaghetti Dinner:  
  free to racers $5.00  
Grand Total:  
 
Personal Information
E-Mail:*   Valid e-mail is required
First Name:*  
Last Name:*  
Address Line 1:*  
Address Line 2:  
City:*  
State:*  
Zip Code:*  
Marital Status:  
Gender:  
Date of Birth:  
Phone:*  
Date of Birth:*   mm/dd/yyyy
Height:*  
Weight:*  
Gender:*
Male
Female
Credit/Debit Card Information
Card Number:*   No dashes or spaces please
Expiration Month:*   From your card
Expiration Year:*   From your card
Card Brand:*  

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