Dye-A-Beat Diabetes 5k Registration
Please use this form to register for Alpha Gamma Delta's Dye-A-Beat Diabetes 5k Color Run. After completing this form, you will be contacted about payment. You will NOT be fully registered until your payment has been received. Student price is $4, general is $6. T-shirts are $12. All proceeds go to the Alpha Gamma Delta Foundation. Thanks for your support! :)
Name
*
First Name
Last Name
Age
*
If under 18, please leave contact information for a parent or guardian here.
E-mail
*
Phone Number
*
-
Area Code
Phone Number
Are you a student?
*
Yes
No
T-Shirt
*
Please Select
Small
Medium
Large
X-Large
2XL
3XL
No shirt
Register
Should be Empty: