2017 Run @ Work
Date: Friday, September 22nd, 2017
Time: 8:00 a.m.
Location: Currituck Cooperative Extension
Email address
Your answer
Phone Number
Your answer
Are you a County Employee ( you do not have to be to participate)
If so, which department to you work in?
Your answer
Which race will you be participating in ?
WAIVER: By typing your name below you , the undersigned declare: I am in good physical condition and am able to run/walk in the Currituck Run at work 5k and 1 mile walk. I will not hold Currituck County Extension or the County of Currituck liable for any injuries or damages incurred during the run/walk.
Your answer
A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
Never submit passwords through Google Forms.
This form was created inside of North Carolina State University. Report Abuse - Terms of Service - Additional Terms