The DCP Run REGISTRATION


Please copy & print the information below and mail it in for registration.

ENTRY FEE 

$20 Students & Seniors / $25 Adults

(On-site registration available)

 

  

Please print and complete form below. Mail in with payment to:

The Detroit College Promise Run, 30100 Telegraph Road, Suite 408, Bingham Farms, MI 48025

 

Event: (circle one)   5K Run    5K Non-Competitive Walk

Name:_________________________________________________   Birth date: ___________ Sex:  M  F

Address:____________________________________ City:_________________ State____  ZIP: _______

Email:_____________________________________________

Phone:  (       )______________________________      T-shirt:  Youth M  L   Adult S M L X XX  

***Entries received by 10/1 are guaranteed t-shirts, after 10/1 while supplies last.***

 

WAIER In consideration of my acceptance of my entry, I for myself, my executors, administrators, and attendees do hereby do release and discharge The Detroit College Promise, all sponsors, organizers, supporters, and spectators for all claims, damages, demands, actions,  whatsoever in any manner arising from my participation in said event. I test and verify that I have full knowledge of the risks involved in this event. I am physically fit and have my personal physician’s approval to participate. Further, I hereby grant full permission to any and all of the foregoing to use my photograph, videotape, motion picture, or record of my participation in this event.

 

X_______________________________________________________­­­________ Date____________________________

Signature of participant or parent/guardian if under 18 years of age.