Community Cupcake Run Registration

Last Name:
 First Name:
 Age:
Gender
Male Female
Address:
 City, State:
 Zip:
Email:
 Phone:
Under acceptance of my entry, I, for myself, my heirs and assigns, hereby release the beneficiary and host organizations, workers, and officials of the CCA Community Cupcake Run from any and all liability arising from damages, illness, or injuries I may suffer as a result of my participation in this event. I attest I am in proper physical condition to undertake this event. I give permission for free use of my name and pictures for publicity purposes for this event. I understand that my entry fee and any additional donations are non-refundable.
 Accept
 
Which Race Are You Choosing?
5k Run
1 Mile Run/Walk
Phantom Runner
(I can't run but would like to make a donation.)
 
If you have any comments or questions:

Information

Contact Mark Ohliger
678.426.1600 Ext. 7
m.ohliger@cumberlandchristian.org

Proceeds benefit Cumberland Christian Academy's Athletic Department. CCA is incorporated as a 501(c)(3) nonprofit educational organization, qualifying to receive charitable contributions which are tax deductible at fair market value.