RW/Reebok sponsored DATE Saturday, June 19, 2004 ONLINE REGISTRATION FORM Please provide the following contact information:
Please select one
Check one... 10 K 9:00AM 5K 9:30 AM ADULT 2 MILE 9:45AM YOUTH 2 MILE 10:15AM
CHECK ONE: TEESHIRT SIZE.... MEDIUM LARGE XLARGE XX LARGE
REGISTRATION - INCLUDES T-SHIRT - WHICH WILL BE MAILED
ADULT REGISTRATION (INCLUDES T-SHIRT) $25.00 ( June 1, 2004 $35.00 )
YOUTH SCHOOL REGISTRATION & TEE $15.00
Participants: to gain entry to the Michelob and other sponsors party, inside Boardwalk Hall, you must present Race Bib and age appropriate ID. Non participants must wear the official race day shirt (available for purchase by using this form) and present age appropriate ID. Outdoor festivities in Kennedy Plaza is open to all age groups with Race Bib or race day shirt. Thank you for your cooperation.
5 pcs $10.00
Online registration total:
Please remember your total (total should included correct shipping fees) after submitting this form you will be redirected to a page to make your payment via Paypal. We take all major credit cards!
I know that competing in a 10K, 5K, or walk can be hazadous activity. I should not enter unless I am medically able and properly trained. Having read this waiver, I for myself and anyone acting in my behalf, waive SCOOPS PRODUCTIONS, The City of Atlantic City, Atlantic City Historic Boardwalk Hall, LLC, ACCVA, Aramark, ACIA and NJSEA. and all sponsors from claims and liabiities resulting in my participation in this event. Submission of application will serve as signature.
Additional information phone 215 474-1057 * [email protected] payment accepted by credit card
