Runner's Name (required)

Runner's Email (required)

Address

Phone

School Name if still in school

Your Age on day of run (required)

Gender(required)

T-Shirt Size: (required) Child MediumChild LargeAdult SmallAdult MediumAdult LargeAdult XLargeAdult XXLarge ($3 extra)

Question or Comment:

By clicking "Send" below... I release and hold harmless the event Sponsors, Town of Summerville, the National Stroke Association, the officials, volunteers, and organizers of the 2019 Hazel Williams Gammons Run for Your Mother 5k from any and all claims of injury or damages that may occur from my participation in this event. I also give my permission for the free use of my name and picture in any broadcast or other written account of this event. I assume any risk, whether resulting from negligence or otherwise, associated with my participation in this event.