Download, print out, sign, and mail the Registration Form to:

Two Street 5K Run
P.O. Box 37490
Philadelphia, PA 19148

Download Registration Form*


Or, you may just simply print out the below registration form:

Registration: $20, Day of Race Registration: $25

Two Street 5K Run/Walk Registration Form

Last Name ___________________________________________
 
First Name __________________________________________
 
Address _____________________________________________
 
City ______________________ State _______ Zip _______
 
Phone _______________________________________________
 
Sex (circle one)      Male       Female
 
Age (race day) _____________ Birth Date _____________
 
Event Entered  (select only one)
 
_____    Open Division
 
_____    Clydesdale (225 lbs. and over)
 
_____    Open Team Name _____________________________
 
_____    Mummers Team Name __________________________
 
Shirt Size
 
_____ Small   _____ Medium   _____ Large
 
_____ X-Large   _____ XX-Large
 
Waiver and Release  -  All entrants must sign!!
 
In consideration for accepting this entry and the granting
of the right to participate in this event, I, the undersigned, 
intending to be legally bound, hereby waive for myself, my  
heirs, personal damages I may have against the Two Street 5K 
Run/Walk, Two Street Irish Society, its partners, officers, 
directors, employees and sponsors, and/or any person whomever 
for any and all injuries, including death that may result from 
my participation in said event.  I represent and affirm that 
I am in proper physical condition to participate in this event 
as verified by a licensed physician and have sufficiently 
trained for the completion of this event.  Further, I hereby 
grant full permission to the above event to use my name and/or 
picture in any newspaper, photographs, video tape, motion 
picture, recordings or any other account of this event for 
any purpose whatsoever and without any obligation of anyone 
to compensate me therefore.
 
The undersigned has read and voluntarily signed this release 
and waiver.
 
___________________________________________________
Signature (Parent/Guardian must sign if entrant is under 18)

____________________
Date