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Four Courts Four Miler Bag Drop
   Saturday, March 10, 2012 (07:30 AM - 09:00 AM)

* Required fields

* First Name:
* Last Name:
* Address:
* City:
* State:
or * Province:
* Zip/Postal Code:
* Country:
* Gender Female Male
* Date of Birth:  
* Email :
* Home Phone:
Work Phone:
Emergency Contact Name?:
Emergency Contact Phone Number?:
Are you a Pacers Ambassador or Staff Member?:
Would you like your Volunteer shift to count towards your 2011 Point Series Standings?
See www.pacersevents.com/series/points.html for more info.:
Are you Volunteering with a group? If so, please enter the name of your group.:
Would you like your Volunteer shift to be counted towards a community service requirement, e.g. high school?
If yes, please bring your form on race day to be validated.:
*Volunteer T-shirt:
Comment
(eg: who you'd like to work with,
or, list second volunteer choice):
 
INFO FOR PARENT/GUARDIAN COMPLETING THIS REGISTRATION
Registration for minors must be completed by a Parent or Legal Guardian. If your age on race day is less than 18 years old, please fill in the Parent/Guardian Contact Information below. Providing such information and continuing this process indicates that this registration was completed by the person listed below.
Parent/Guardian Name:
Contact Phone:
Contact Relationship: