Use this form to register for the individual 5K race and walk.
 

Contact Information

Title
First Name*
Middle Name
Last Name*
Country*
Address*
City*
Postal Code*
Email*
Confirm Email*
Phone*

Alumni Information

I'm an Alum of:
  • CU Undergraduate
  • Professional and Graduate Studies
  • Grand Rapids Theological Seminary

Additional Registration Information

Gender*
Age group on race day:*
Shirt Size*
Emergency Contact Name*
Emergency Contact Phone Number*

 

I recognize that there is a risk of personal injury associated with participation in this event and I assume full responsibility for such risk. I will not participate unless I am medically able and properly trained. I hereby release and waive any claims that I might have or claim to have against Cornerstone University and event sponsors arising from my participation in this event - INCLUDING any claims for personal injury (Note: parent or guardian must sign if participant is under 18).


 
Waiver and Release*
  • I have read and understand and agree with the terms

Registration Code

Enter "1" for Security Code*

Payment Information

Amount*
$
Card Type*
Name on Card*
Card Number*
Expiration Month*
Expiration Year*
Additional Comments

Security Code

Type the text shown in the box into the field below. All characters must be entered in UPPERCASE.

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