Clone of Rhoyal Poodle Dash Race Registration Form

Sigma Gamma Rho Sorority Inc.

Mu Beta Sigma Alumnae Chapter

5K Fun Run/Walk, Scholarship Fundraiser

Location: NYOS Charter School

12333 N Lamar BLVD, Austin TX 78753

Race Date: Saturday, May 4, 2024

Time: 7:00 am-12:00 Noon

Race Check-in: 7:00 am-8:30 am

Race Starts at 8:30 am
Registration Information
Full Name

First NameLast Name
Age
Email
example@example.com
Phone Number
Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact Person

First NameLast Name
Emergency Person Phone Number
Format: (000) 000-0000.
T-shirt Size
Are you a Mu Beta Sigma Soror or Affiliate?
Name of Soror who referred you.
Waiver & Release
Read and check each box
Participant's Signature
Date Signed

MonthDayYear
Date
Parent/Guardian Signature (If participant is below 18 years old)
Registration Payments
My Products
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Registration/Donation Fee - Fun Run/Walk
(includes t-shirt)

$40.00 QuantitySize

Donation Only - Support MBS with a monetary gift!
Please select a donation amount

Free

Total

$0.00