Ferris Lane Youth Group Fun Run Registration Form

• Your Name*
  Your contact details are being collected for the sole purpose of registration for the Fun Run, and issuing charitable receipts after the event. We will not share, or sell your information to any third parties.
  First Name

  Last Name
• Your Email*
   
• Phone*
   
• Address
  Street Address

  Address Line 2

  City

  State / Province / Region

  Zip / Postal Code

  Antigua and BarbudaBahamasBarbadosBelizeCanadaCosta RicaCubaDominicaDominican RepublicEl SalvadorGrenadaGuatemalaHaitiHondurasJamaicaMexicoNicaraguaPanamaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesTrinidad and TobagoUnited StatesArgentinaBoliviaBrazilChileColumbiaEcuadorGuyanaParaguayPeruSurinameUruguayVenezuelaAlbaniaAndorraArmeniaAustriaAzerbaijanBelarusBelgiumBosnia and HerzegovinaBulgariaCroatiaCyprusCzech RepublicDenmarkEstoniaFinlandFranceGeorgiaGermanyGreeceHungaryIcelandIrelandItalyLatviaLiechtensteinLithuaniaLuxembourgMacedoniaMaltaMoldovaMonacoMontenegroNetherlandsNorwayPolandPortugalRomaniaSan MarinoSerbiaSlovakiaSloveniaSpainSwedenSwitzerlandUkraineUnited KingdomVatican CityAfghanistanBahrainBangladeshBhutanBrunei DarussalamMyanmarCambodiaChinaEast TimorIndiaIndonesiaIranIraqIsraelJapanJordanKazakhstanNorth KoreaSouth KoreaKuwaitKyrgyzstanLaosLebanonMalaysiaMaldivesMongoliaNepalOmanPakistanPhilippinesQatarRussiaSaudi ArabiaSingaporeSri LankaSyriaTaiwanTajikistanThailandTurkeyTurkmenistanUnited Arab EmiratesUzbekistanVietnamYemenAustraliaFijiKiribatiMarshall IslandsMicronesiaNauruNew ZealandPalauPapua New GuineaSamoaSolomon IslandsTongaTuvaluVanuatuAlgeriaAngolaBeninBotswanaBurkina FasoBurundiCameroonCape VerdeCentral African RepublicChadComorosCongoDjiboutiEgyptEquatorial GuineaEritreaEthiopiaGabonGambiaGhanaGuineaGuinea-BissauCôte d\'IvoireKenyaLesothoLiberiaLibyaMadagascarMalawiMaliMauritaniaMauritiusMoroccoMozambiqueNamibiaNigerNigeriaRwandaSao Tome and PrincipeSenegalSeychellesSierra LeoneSomaliaSouth AfricaSudanSwazilandTanzaniaTogoTunisiaUgandaZambiaZimbabwe

  Country
• Distance/Race*
  >5K - $20 Minimum Donation2K - $20 Minimum DonationKids: 6 & Under - $15 Minimum DonationKids: 7-10 - $15 Minimum DonationKids: 11-14 - $15 Minimum DonationDonation Onlly (not running/walking)
• Payment Notes
  Please email your registration donation to ferrislanegives@rogers.com (no security question necessary, but please note that it is for the Fun Run in the message to recipient) or bring a cheque or cash (exact change) to the race on August 4th. Charitable donation receipts will be provided for all donations $15 and above. Cheques should be made payable to Ferris Lane Community Church. If you are emailing your donation, please note the name of the account holder below so that your donation can easily be matched to your registration.
• Team Name
  If you are part of a team, please note below so that we can gather your details for team spirit prizing eligibility

NOTE: Do Not Alter These Fields:

Subject