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Step 1 of 2 - Family Registration |
Head of Family's First Name | Last Name
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Address 1
| Address 2
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City
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State / Province
Use 2 digit code for US and Canada otherwise, leave blank. | Country, if outside of the U.S. and Canada
Leave blank if address is in US or Canada. |
Zip / Postal Code
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Primary Phone Number
Required... please provide your primary number. | Other Phone
Optional... provide an alternate phone number. |
Email Address
Your active Email Address... check for accuracy. |
Head of Family's Date of Birth
Format: YYYY-MM-DD | Sex
M for Male, F for Female. |
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| | | | Apparel Description Be sure to register early to guarantee your size! | | | | |
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Shirt Selection
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Student Selection
Optional... is this participant a student in the range of kindergarten through 12th grade? If so please choose "Yes" from the drop-down selector. |
Name of School
Students only... if this participant is a student please provide their school name. |
Non Runners
Optional... are you a non runner? If so, please identify yourself by choosing from this drop-down selector. Non runners receive a discount off base registration fees and will not participate in our race. Non runners may attend our health and wellness fair after the race, which features various activities and classes for all ages! |
How did you hear about our St. Juliana School Trojan Trot?
Optional... help make our race better by letting us know how you found us. Example: "saw neighborhood sign / flyer", "received email notification", "referred by friend" |
Charitable Donation
Optional... please consider an additional charitable donation. Our race is a fund raiser and with your help we will donate race proceeds. |
Number of Runners for Your Family (2 to 8)
Total number of runners for your family... You plus the number of your family members. |
Waiver
In consideration of acceptance of this entry, I hereby acknowledge that there are certain risks inherent in participation in this event and hereby assume such risks. I hereby forever discharge and release St. Juliana School and St. Juliana Parish, Archdiocese of Chicago, the Event, its sponsors, their agents, employees, officers, directors, successors and assigns, Chicago Department of Transportation, Chicago Police Department, Chicago Fire Department and the City of Chicago from any liability in this event and I voluntarily assume all risks and hazards. This waiver and release binds me, my heirs, next of kin and executors. I grant permission to use my name and any photographs, video or any other record of my participation for any reasonable purpose. Agree to waiver by checking here.By agreeing to this waiver you submit to the terms and conditions as set forth by this event and certify that you have provided true and accurate information as requested through this registration process. |
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