*1.First Name(Required.)

*2.Last Name(Required.)

*3.Email(Required.)

4.Phone Number (optional)

*5.Are you a Tri-C employee or student?(Required.)

Employee

Student

None of the above

*6.If you are a community member, what company or organization are you affiliated with? (If not applicable, please write n/a)(Required.)

*7.Will you be walking or running?(Required.)

Walk

Run