SurveyMonkey Powered Online Survey

Saturday, June 1, 2013
Registration 8:00 - 8:40 am
Doctor's Park, 218 S. Main Street, Lodi, WI
Last shuttle to event start leaves at 8:40 am

Please RSVP by May 27 to help us plan with your needs in mind.

Important: Please fill out one survey for each person participating.

Note: Please bring your signed registration form and donations to event.

Question Title

* 1. Please enter your contact information.

First Name

Last Name

Address

City

State

Zip

Phone

Email Address

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* 2. Are you participating in a team?

Yes

No

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* 3. Age Category

14 and under

15 and up

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* 4. Gender Category

Male

Female

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* 5. To help us plan transportation needs to the event start, please indicate your event.

1K Kids Run (10 and under)

6K Walk

6K Run

8K Run