2019 Missouri State Employee 5K Registration

September 14, 2019

Race starts at 8 a.m. at North Jefferson City Pavilion

$20 Entry Fee

Register and pre-pay by August 30th to receive a shirt.

Registrant Information

Question Title

* 1. Registering as

5K Participant

Question Title

* 2. Gender

Male

Female

Question Title

* 3. Age

Under 19

20-29

30-39

40-49

50-59

60+

Question Title

* 4. Contact Information

Full Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

Question Title

* 5. Emergency Contact

Full Name

Relationship

Phone Number

Question Title

* 6. If you are a state employee, please choose the department you are representing.