Wufoo

Online Early Registration

Name * First Last
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone * ### - ### - ####
Email *
Date of Birth *
Age *
Gender *
Male Female
T-Shirt Size *
M L XL Youth Small Youth Medium Youth Large

T-Shirts are only guaranteed to first 300 entries and are for Run & Walk participants only.
I agree to the waiver on liveitupevansville.com for the Run & Walk event. I understand that my online registration will not be completed until payment has been electronically received by the Evansville Courier & Press via the website I will be redirected to after I submit this form. *
I Agree To These Terms
Do Not Fill This Out