Register For Class

First Name:

Last Name:

Email:

Phone:

Address:

City:

State:
Select State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip:

Class
Running
Walking
Both

Shirt Size
S
M
L
XL

Liability Waiver and Release: Upon acceptance of my entry, I, for myself, my heirs & assigns, hereby release the sponsors & coaches of the Good Form Running and Walking Clinic from any and all liability arising from illness, injury or death I may suffer as a result of my participation in this event. I am aware that my participation could, in some circumstances, result in physical injury. I give permission for the free use of my name and picture in any broadcast, telecast, or written account of this event. I understand that the entry fee is NON-REFUNDABLE.