2019 Pump House Run Registration
>>>>>>SUBMIT ONE REGISTRATION PER RUNNER<<<<<
******If registering a family, please complete a separate form for each runner******

**Please check all information prior to submitting the form. Any errors will cause problems with Timing on race day.**

Race Day: Saturday May 18th (Race day registration begins at 7:30, Race Begins at 9)
Fee: $15 Individual Registrations, $35 for family ($5 more per registration after April 26th)
Shirt: Included with early registration (up to 3 per family registration)

NO SHIRT GUARANTEE FOR LATE/RACE DAY REGISTRATION.

EARLY REGISTRATION DEADLINE: APRIL 26th

Sponsor/donate to The PUMP HOUSE RUN - CLICK BELOW. - Do you have a service or business you would like to publicize in the NA community.
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Demographics
Please complete 1 form per person. (Example: If you have 3 people in your family running, you should complete 3 forms.) Do not put multiple people on one form.
First Name *
Your answer
Last Name *
Your answer
Email Address
(For Post Race Photos and reminder for future Pump House Run events.)
Your answer
Age on Race Day *
Your answer
Phone number
Your answer
Race Information
Race *
Gender *
Age Group *
Only for Ages 8-12 in the 1 Mile and all 5K runners.
Shirt_Size (Please note: Only 3 shirts per family registration) *
Registration Type *
Please list the name(s) of others under your family registration. This allows us to connect families to 1 payment. (Family Registration Only)
Your answer
School Affiliation *
Required
Athlete/Guardian Waiver (Must be signed to compete) In consideration of the acceptance of my entry, on behalf of my heirs, executors, my administrators, assigns, and myself do hereby release and discharge North Allegheny School District, and all race officials, from claims for damages, demands, actions whatsoever in any manner arising or growing out of risks involved in these events and I also certify that I am physically qualified to participate in these events. *
Your answer
Payment
Payment can be made in one of 2 ways.
1) Send check made payable to "NA PUMP HOUSE RUN" into school and give to your PE Teacher
2) Send check via mail to: PUMP HOUSE RUN
Attn: Bill Love
350 Cumberland Road
Pittsburgh, PA 15237

Your registration and shirt order will not be complete until payment is received.

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