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House of Hope 5K Registration Form
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Price Schedule
Through
09/08/2025
Final
5K - 5K with official timing
$35
$40
WA - 5K with no official timing
$35
$40
Categories
*
5K - 5K with official timing
- $35.00
WA - 5K with no official timing
- $35.00
Participant Information
Contact Email
*
Participant First Name
*
Participant Last Name
*
Participant Birthdate
*
- month -
Jan
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- year -
2025
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Participant Gender
*
Female
Male
Country
*
-- select country --
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United States
Street Address (w/Apt#)
*
City
*
State
*
-- select state --
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-- select state --
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Col.
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
-- select province --
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Zip Code
*
Phone
*
Would you like to
receive important event text alerts
on this number (eg. changes or delays)?
Emergency Contact
*
Emergency Phone
*
T-Shirt Size
*
-- select one --
AS
AM
AL
AX
XX
"A" means Adult. Sizes are guaranteed to all entered NLT 9/8.
Fundraising Team
*
new fundraising team
- select a fundraising team -
I am not on a fundraising team
Make a Donation
House of Hope
click here
, to learn more about this cause
Amount $
House of Hope of NC has been serving individuals and families in our community for over 25 years with a passion for Christ-centered, clinically-excellent counseling, whether that is through our residential program for teenage girls or our outpatient counseling center for teens and adults.
Waiver
*
I have read and agreed to the TERMS
*
CLICK HERE TO VIEW THE TERMS
.
Is the participant 18 or older?
*
18 or older
Under 18
Parent or Legal Guardian’s Signature - By providing your electronic signature you agree that you have the authority to register these participants and agree to the waiver(s) for them as their parent or legal guardian.
If registering a child under 18, you are consenting to the collection of the child's information that you are providing for the purposes of registration.
Parent's signature
Do you want to be added to our mailing list for updates on upcoming events?
Payment Details
Discount or Tracking Code
Apply
Do not COPY & PASTE the code, please type it into this field.
Price
$
Discount (-)
$
Total
no handling
$
Handling
$
Donation
$
Total Owed
$
Payment Method
The payment and credit card section is not visible because there is nothing owed or form fields have not been fully completed.
Visa
Mastercard
Payable To:
Address:
click the "submit" button to submit your order then send a check to (or pay in person at) the address above.
1. Venmo the total amount to the Phone #:
2. Make sure you enter the code,
68723
in "What's it for".
3. Click the "pay now" button.
Enter a Check Number
Enter a Check Amount
Send email receipt to the participant
Send email receipt to the participant
Purchase
Purchase
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