Register for Imadi Chesapeake Bay Bridge 10K

Registration Information

First Name: *

Last Name: *

Address: *

City: *

State: *

Zip / Postal: *

Country: *

Phone Number: *

Additional Phone Number:

Email Address: *

Gender: *

Male Female

Date of Birth: *

Jersey Size: *

Shirt Style: *

Emergency Contact Information

Emergency Contact: *

Emergency Phone: *

Fundraising Commitment

SINGLE RUNNER I understand that by participating in the Chesapeake Bay Bridge 10K, I am committing to raise a minimum of $1,000.

COUPLE I understand that by participating in the Chesapeake Bay Bridge 10K, I am committing to raise a minimum of $1,800.

CHILD WITH A PARENT I understand that by participating in the Chesapeake Bay Bridge 10K, I am committing to raise a minimum of $250.

Account Information

Custom URL:* Create your custom url to use for your personal fundraising page (This will also be your account username)

https://www.rayze.it/imadi/

Sign in with Google or choose a password. You will need it to view / edit your personal web page, and see who has sponsored you for this event.

Password: *

Re-Type Password: *

Additional Information optional

Additional Comments:

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