|Attention... registration for this event closed on Thursday October 31st, 2019 - Noon (USCT).|
|Race Name:||Pairing up to Beat Lung Cancer 5K/1 Mile Run/Walk|
|Location:||Midtown Athletic Club, Palatine, IL|
|State:||Illinois, United States|
|Posted:||March 1st, 2019 10:40 am|
|Last Update:||October 28th, 2019 7:44 pm|| |
|Name of Event:||Pairing up to Beat Lung Cancer|
|Date:||Saturday November 2nd, 2019|
|Start Time:||8:30 am|
|For kids 15 and under and seniors 65 and over, an automatic discount of $10.00 will be applied|
|Event Registration Schedule|
|Opened:||Friday March 1st, 2019||Noon|
|Deadline passed:||Saturday August 31st, 2019||Midnight|| $25.00|
|Deadline passed:||Thursday October 31st, 2019||Noon|| $30.00|
|Step 1 of 2 - Participant Registration|
|Address 1||Address 2|
|State / Province|
Use 2 digit code for US and Canada
otherwise, leave blank.
|Country (only if outside of the U.S. and Canada)|
Leave blank if address is within US or Canada.
|Zip / Postal Code|
|Primary Phone Number|
Required... please provide your primary number.
Optional... provide an alternate phone number.
Participant's active Email Address... check for accuracy.
|Participant's Date of Birth|
Gender: M for Male, F for Female.
How did you first learn about our Pairing Up To Beat Lung Cancer charity run?
Optional... help make our race better by letting us know how you found us.
Example: "I ran last year", "saw neighborhood sign / flyer", "received email notification", "referred by friend".
"Pairing Up" Teammate Name, Sex, Age
Optional, for 5k only... would you like to "pair up" and participate in our special 2-person scoring competition? If so, enter your teammate's Full Name, Sex, and Race Day Age. Your finishing time will be combined with your teammate's time, and together your team will be scored against others within age-graded categories of Male, Female, or Mixed.
Note... participation requires each teammate to be pre-registered in our 5k race. This category is not available to race-day entries!
Are you a Lung Cancer Survivor?
Optional... if you're a "lung cancer survivor" you may identify yourself by selecting this option, otherwise leave blank.
Optional... please consider an additional charitable donation. As a fundraiser, all proceeds are donated to the Northwest Community Healthcare Foundation.
In consideration of your accepting this entry, I, the below signed, intending to be legally bound, for myself, my heirs,my executors and administrators, waive and release and any all rights and claims for damages I may have against the race, sponsors and their representatives, successors and assigns for any and all injuries suffered by me in said event. I attest that I will participate in this event as a footrace, that I am physically fit and sufficiently trained for the completion of this event. Furthermore, I hereby grant full permission to use my name and likeness, as well as any photographs and any record of this event in which I may appear for any legitimate purpose, including advertising and promotion 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.