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25th Annual Race Registration
Should you decide to mail the registration, our address is 2437 Welch Blvd, Flint MI 48504
Please complete and submit
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Indicates required field
First Name
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LAST NAME
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MIDDLE INITIAL
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Cell Phone
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Home Number
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Other Number
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Email
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Address
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Line 1
Line 2
City
State
Zip Code
Country
Date of Birth
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OCCUPATION
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EMERGENCY CONTACT NAME
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EMERG. PHONE
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COMPANY YOU ARE RUNNING/WALKING FOR?
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Please write down your shirt size
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HOW DID YOU HEAR ABOUT OUR CLINIC?
*
Submit Application
Home
About
How you can support
Executive Board
Volunteer App
WISH LIST
Happenings