Harris House Run and Walk for Recovery

First Name (Separate Registration Needed For Each Participant)(Required)

Last Name(Required)

Age(Required)

Gender(Required)

Male

Female

Prefer not to disclose

Pick Event:

5K Run/Walk (Timed Run)

1 Mile Walk (Great for Families)

¼ Mile Kiddie Dash (Perfect for kids 12 and under)

Shirt Size (First 300 Participants)(Required)

Email(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Name(Required)

First Last

Date(Required)

Insurance Providers