Robert Community House 5K Run for Roberti Registration

Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Let everyone walk with pride! Sponsor a neighborhood group!

Many of our community members struggle to meet their own basic needs yet still volunteer their time and talents at RCH. Help them participate by sponsoring a neighborhood group.
How would you like to participate?*

Register for the 5K walk/run onlyRegister for the 5K walk/run and Sponsor a GroupCan't Participate in the 5K but would like to Sponsor a Group
How may runners would you like to sponsor?*

4 for $10010 for $200
Total Cost of Sponsoring a Group*
Register Walk/Runners
Number of Runners*
$35 per person or $120 for a family pack of 4
Runner #1 Name

First NameLast Name
Runner #1 T-Shirt Size*
Runner #2 Name

First NameLast Name
Runner #2 T-Shirt Size*
Runner #3 Name

First NameLast Name
Runner #3 T-Shirt Size*
Runner #4 Name

First NameLast Name
Runner #4 T-Shirt Size*
Total Runners Registration Fees*
T-Shirt Pick-Up
T-Shirt Pick-Up Options*

Pick up at the Roberti Community House, 919 8th Street, Waukegan, IL: 5/29-6/9 (Mon-Fri, 9am to 4pm)I'm out of state and need my t-shirt shipped (there is an additional $5 fee for shipping).I have arranged a different pick up with Roberti Community House.
Please provide the address where you would like your t-shirt(s) shipped?*

Same address listed aboveDifferent address
T-Shirt Shipping Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Shipping Fee*
Total Registration Fees
Total Registration Amount*
How Would You Like to Pay for Your Registration?*

CheckVenmoPayPal, Debit, or Credit Card
Please make your check payable in the amount of {totalRegistration47} to "Roberti Community House", add "5K" to the memo line and mail your check to:

Roberti Community House
P.O Box 65
Lake Forest, IL 60045
Please make your payment in the amount of {totalRegistration47}, add "5K" to the memo and pay via Venmo by scanning the QR Code below:
Please make your payment in the amount of {totalRegistration47} via PayPal.
Total Donation
Total Amount to Pay via PayPal

prevnext( X )
USDDescription

Should be Empty:

First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Let everyone walk with pride! Sponsor a neighborhood group!

Register Walk/Runners

T-Shirt Pick-Up

Total Registration Fees