Hanover College

Saturday, October 14, 2017
Race day registration will begin at 7:30 a.m. with the race beginning at 8:30 a.m. Race packets will be available during this time for pre-registered runners. After the pre-registration date, t-shirts will be given out on a first-come, first-served basis while supplies last.

The run/walk will begin at The Point on the Hanover College campus and will include rolling hills, and several turns.

• Awards given to overall top runners and in age categories
• T-shirts guaranteed to all pre-registered runners/walkers
• Water and fruit available
• All proceeds benefit the Hanover College Wellness Program

Registration Fees

• $15 for pre-registrations received by Wednesday, October 11, 2017
• $20 for day-of-race registration

If you have any questions please contact Molly Jones, jonesm@hanover.edu

Name

Phone (best number to reach you)

Email

Address

City

State

Select

Zip

Entrant Details

Age

Gender

MaleFemale

Runner or walker

RunnerWalker

Shirt size

SMLXL

Waiver: I hereby waive, release, and discharge any and all claims or liability of Hanover College and anyone in conjunction with the race and my participation in this event. By registering, I ensure that I am physically fit enough to participate.

Electronic signature

Parent electronic signature (required if under 18)

Payment Information

Card Number

Expiration

MM010203040506070809101112 / YYYY

CSC

Signature and digits from card #123

On most cards, the 3-digit card security code (CSC) is on the back, to the right of the signature.

XXXX XXXXXX XXXXX1234

On American Express cards, the 4-digit card security code (CSC) is on the front, to the top-right of the card number.

Email Address

Card owner email address; used for email confirmation and receipt.

Confirm Email Address

Must match card owner email address.

First Name

Last Name

Address

City

Country

State

Select

Zip/Post Code

Phone Number

Payment Service Fee

An additional service fee of $0.00 will be added to the payment amount.

Payment Authorization

I authorize Hanover College to initiate a charge to my Credit/Debit Card the amount of $0.00 for: The Scenic.

Please be sure to review all your information for accuracy before submitting this form.