Jack-O-Lantern Jog Registration   -  October 30, 2021

or online at  https://www.active.com/canonsburg-pa/running/jack-o-lantern-jog-2021

Must be postmarked by October 21, 2021.

 

Name_____________________________________________      Phone _________________________________

Address _______________________________________________________________________________________

City ___________________________________              State _______            Zip code __________________

Email _________________________________________________________________________________________

PERMISSION TO PHOTOGRAPH AND PUBLISH PHOTO.

I hereby grant permission for any photo taken of me during the race to be used on the Community Scholarship Foundation of Canon-McMillan's website, Facebook page and in any and all press releases

Signature ________________________________________________ (parent/guardian if under 18)

Shirt Size:              Youth M ______  Youth L ______                           Adult  S____  M _____ L _____ XL _____ XXL_____

Registration  5K Race/Walk Entry @ $28.00 pre registration each                                 _______

Registration Skeleton Stroll @ $23.00 preregistration each (not scored)                     _______

                                                 Subtotal                                                               _________

 

                                                                                TOTAL                                          __________

Make checks payable toCSFCM  (Community Scholarship Foundation of Canon-McMillan)  Send Entry to Jill Sabol (Jog), 120 Lakewood Drive, Canonsburg, PA 15317