Run/Walk for Periyar Registration Form

Run/Walk for Periyar 148
Email

Confirmation Emailexample@example.com
Name

First NameLast Name
Location of Run/Walk

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Distance Completed

Other
Date of Run/Walk

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Fitness App Screenshot Upload

Cancelof
Notes:
- You need to start your run on the start date.
- Your run should be completed before the deadline.
- Certificates will be sent to your email address.
- We recommend you prioritize your health and safety.
- We are not responsible or liable for any damage or injury that might happen during the course of the event.
I confirm that I completed the run/walk as part of Run for Periyar between Sep 1 and Sep 29, 2026.
Please verify that you are human
Should be Empty:

Run/Walk for Periyar 148