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2024 Pumpkin Run Registration Form
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Categories
*
Pre-K (2024-2025 School Year)
- $10.00
Kindergarten (2024-2025 School Year)
- $10.00
1st Grade (2024-2025 School Year)
- $10.00
2nd Grade (2024-2025 School Year)
- $10.00
3rd Grade (2024-2025 School Year)
- $10.00
4th Grade (2024-2025 School Year)
- $10.00
5th Grade (2024-2025 School Year)
- $10.00
Middle School (2024-2025 School Year)
- $10.00
Parent/Guardian/Sibling of Runner
- $10.00
Teacher
- $10.00
School (select Homeschool if appropriate)
*
-- select one --
Adams
Arnold
Beattie
Belmont
Blessed Sacrament
Bluestem Montessori
Brownell
Calvert
Campbell
Cathedral of the Risen Christ
Cavett
Ceresco
Christ Schools
Clinton
College View
Culler
Dawes
Don D. Sherrill Education Center
Eagle Elementary
Eastridge
Elliott
Evelyn Hamlow
Everett
Faith Lutheran
Fredstrom
Garfield
Goodrich
Good Shepherd Lutheran
Haines Branch
Hamlow Elementary - Waverly
Hartley
Hatfield
Havelock
Hedge Hill
Hill
Holmes
Holy Family
Homeschool
Humann
Huntington
Irving
Kahoa
Kloefkorn
Kooser
Lakeview
Lincoln Christian
Lincoln Lutheran
Lefler
Lux
Malcolm
Maple Grove
Maxey
McPhee
Meadow Lane
Messiah Lutheran
Mickle
Milford Elementary
Morley
Moore
Norris Elementary
Norris Intermediate
Norris Middle School
North American Martyrs
Norwood Park
Nuernberger Education Center
Oak Valley
Olive Branch
Park
Parkview Christian
Pershing
Pioneer
Pound
Prairie Hill Learning Center
Prairie Hill Montessori
Prescott
Pyrtle
Randolph
Riley
Robinson
Rokeby
Roper
Rousseau
Sacred Heart
Saratoga
Schoo
Scott
Sheridan
St John's
St Joseph's
St Mark's
St Mary's
St Michael's
St Pat's
St Peter's
St Theresa's
St Vincent de Paul
Trinity Lutheran
Two Springs
Valparaiso Elementary
Villa Marie
Waverly Intermediate
Waverly Middle School
West Lincoln
Westfall
Westminster
Wysong
Zeman
Other
School - If Other
Homeroom Teacher
*
Shirt Size
*
-- select one --
Youth Small (6-8)
Youth Medium (10-12)
Youth Large (14-16)
Adult Small
Adult Medium
Adult Large
Adult XL
Adult XXL (+$1) - $1.00
Adult XXXL (+$2) - $2.00
Participant Information
Contact Email
*
Participant First Name
*
Participant Last Name
*
Participant Birthdate
*
- month -
Jan
Feb
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Apr
May
Jun
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- day -
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- year -
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
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2010
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1928
1927
1926
1925
1924
1923
1922
1921
1920
1919
Participant Gender
*
Male
Female
Country
*
-- select country --
Canada
International
United States
Street Address (w/Apt#)
*
City
*
State
*
-- 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 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 Name
*
Emergency Phone
*
Make a Donation
Pumpkin Run Adopt-an-Athlete
click here
, to learn more about this cause
Amount $
Join us in making dreams come true! Your generous donation will create unforgettable memories for children who might otherwise miss out on the joy of the Pumpkin Run. Let's ensure every child has the chance to laugh, play, and feel the thrill of this special event.
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
Payment Details
Discount or Tracking Code
Apply
Do not COPY & PASTE the code, please type it into this field.
Price
$
Discount (-)
$
Total
no handling
$
Processing
$
Donation
$
Total Owed
$
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