spefindividual

Diploma Dash Online Single Registration

Please complete this form to register for the Diploma Dash run/walk and order t-shirt. After you submit your registration, you will be taken to a secure payment site to pay for your registration. Registration is not complete until payment has been made.

First Name

required

Last Name

required

Address

required

Address line 2

City

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State

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Postal / Zip Code

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Phone Number

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Email

required

Sex

Male Female

required

School or Team

I am registering as a:

Student - 18 and under ($10.00) Staff ($15.00) Other ($15.00)

required

Registering for:

1 Mile Walk 1 Mile Run 5 K Walk 5 K Run

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If you registered for the 1 mile walk/run, select a 2013-14 Grade or N.A.

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If you registered for the 5 mile walk/run, select Award Division or N.A.

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Youth and Adult T-Shirt Sizes

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T-Shirt Color

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Click Here to Read Our Waiver.

Your signature indicates that you have read and agreed to the terms of the waiver.

Your Signature

required

Comments

You will be taken to a secure payment page after submitting this form. Please enter your credit card information on that page to complete your registration. Your registration is not complete until you do this.

Thank you for supporting the Diploma Dash.