ATTENTION: Please register each individual separately.
Name  * 
Date of Birth  * 
Sex  * 
Address  * 
City  * 
State  * 
ZIP  * 
Your Email Address  * 
Register me for the 5K:
If registered for the 5K + Shirt & Gift Bag, what is your shirt size?
Register me for the 1 Mile Fun Walk
Register me for the Kids' Race (12 & under)
Extra shirts may be ordered but supplies may be limited!
I would like an extra shirt ($15)
WAIVER (MUST BE SIGNED) In Consideration of the acceptance of my entry, I for myself, my executors, administrators, and assignees, do release, discharge, and hold harmless
The Grace Race, New Life Baptist Church and Westminster College and their clergy, staff, members, administrators, and sponsors from any and all claims, damages, demands, or causes
of action whatsoever in any manner directly or indirectly arising out of or related to my participation in said athletic event; I am physically fit and have sufficiently trained to
participate in this event. By signing below, I give permission to use my likeness without compensation in photographs for the purposes of promoting the Grace Race. I agree to abide
by all rules of participation and acknowledge that the race committee may refuse or return any entry at its discretion.
Electronic Signature  * 
Total $
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