Name *Phone *Address *Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEmail *Gender *MaleFemaleT-Shirt Size: *MediumLargeX LargeXX LargeEvent: *10K Run5K Run5K WalkAge Group: *13 and Under14-1920-2930-3940-4950-5960-6970+Your age group should be selected based on your age as of race day. In consideration of your acceptance of my application for entrance in the Scottdale Fall Festival 10K Run/ 5K Walk / 5K Run, I, for myself and anyone entitled to act on my behalf, waive and release the Scottdale Fall Festival, all Sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event. Signature - (please type your name) *Date / Time * Please note once you complete the form and hit the submit button, you will be directed to PayPal to complete payment.EmailSubmit
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