Online Registration Form

33rd Annual Corktown Race
3/15/2015

Early fees through March 1st ...

  9:30 am - $15 - Kids Quarter Mile
  9:40 am - $20 - NEW Dublin Dash Mile
10:00 am - $30 - 5K Corktown Race
There will be a convenience fee of $2.95 per runner for order processing. Online registration closes on 3/13/2015 at 6pm EST
Refund Policy: NO REFUNDS unless you have been double charged or accidentally signed up more than once.
* indicates required field


The following step requires you to complete the payment process. Please do not submit your registration until you
have your credit card ready.

REGISTERED RUNNERS and Limits    
      
  5K                         Dublin Dash
Mile               
 
12000
0
1000
0

Additional Runner Information

First Name*:
Last Name*:



Address*:
City*:
State*:
Zip Code* (5 digit US / 6 digit Canada - NO SPACES OR DASHES):
Phone Number*:
E-Mail*:
Age*:
Gender*:
Shirt Size*:


Before 3/2/2015
Race*:


Team Name(Optional):

Remove Runner

Runner Information

First Name*:
Last Name*:
Address*:
City*:
State*:
Zip Code* (5 digit US / 6 digit Canada - NO SPACES OR DASHES):
Phone Number*:
E-Mail*:
Age*:
Gender*:
Shirt Size*:


Before 3/2/2015
Race*:


Team Name(Optional):



HELP US REACH OUR GOALS !
7000
Donate to the
St. Patrick's Food Program
$

St. Patrick's Food Program
 
7000
Donate to the
CHASS
$

CHASS
 
 

Promo Code:


I hereby release and hold harmless of myself, my child, and/or representatives, the City of Detroit, Everal Race Management, the event sponsors and organizers from liability for injuries or damages which I or my child may sustain while participating in this activity even if the injuries are caused by the sole negligence of the City or the sponsors or event organizers. I understand that I am responsible for medical coverage for me and my child.

I have read and agree to the above terms.

Refund Policy: NO REFUNDS unless you have been double charged or accidentally signed up more than once.

A confirmation of your registration will be emailed to you immediately.

Please do not submit until you're ready to pay

Your credit card will be charged as...
Everal Race Management
24500 Goddard Rd.
Taylor, MI 48180
Phone: 734-507-1789




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