Saint Mary of Victories Catholic Church

Please enter information on this form to make payment for Runner Registration. Please click Submit below, then be sure to submit PROCESS PAYMENT at the bottom of the NEXT SCREEN to complete payment (even if you are paying by check).

If you are paying by check, please make check payable to "St. Mary of Victories Catholic Church, and remit payment to this address:

St. Mary of Victories Catholic Church
744 South 3rd Street
St. Louis, MO 63102

Salutation*

Please select one.

First Name*

Last Name*

Address*

City*

State*

Phone*

Email*

Race T-Shirt Size*

Choose a size.

Gender*

Waiver Must Be Read and Signed - I know that running a race is a potentially hazardous activity and that I should not enter the event unless I am medically able and properly trained. I agree to abide by any decision of an event official relative to my ability to safely complete the event. I assume all risks associated with running or walking in this event including, but not limited to: falls, contact with other participants, the effects of the weather, including high heat and/or humidity, traffic and the conditions of the road, all such risks being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of your accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release the organizers of the St. Louis Rosary Run, or St. Mary of Victories Catholic Church, or the Archdiocese of St. Louis, volunteers or paid employees, our sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event or carelessness on the part of the persons named in this waiver. Further, I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for legitimate purposes. All fees are nonrefundable. Clicking yes on this form constitutes your agreement and signature.

Age*

I am 18 years old, or older and I have read and acknowledged the waiver.*

Yes No

Registration Selection*

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Second Runner

Will you be registering a second runner/walker?

Additional Runner 1 - First Name

Additional Runner 1 - Last Name

Additional Runner 1 - Gender

Male

Female

Additional Runner 1 - Age

Add'l Runner 1 T-Shirt Size

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Add'l Runner 1 - EMail

Add'l Runner 1 - Registration Type

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I am 18 years old, or older and I have read and acknowledged the waiver. (2)*

Yes No

Third Runner

Adding a third runner/walker?

Additional Runner 2 - First Name *

Additional Runner 2 - Last Name *

Add'l Runner 2 - Gender *

Male

Female

Add'l Runner 2 - Age *

Add'l Runner 2 T-Shirt Size *

Extra Small Small Medium Large XL 2X 3X

Teammate 2 - EMail *

Add'l Runner 2 - Registration Type*

Select one.

I am 18 years old, or older and I have read and acknowledged the waiver. *

Yes No

Fourth Runner

Adding a fourth runner/walker?

Additional Runner 3 - First Name

Additional Runner 3 - Last Name *

Add'l Runner 3 - Age *

Add'l Runner 3 - Gender *

Male

Female

Add'l Runner 3 - EMail *

Add'l Runner 3 - Registration Type*

Select one.

I am 18 years old, or older and I have read and acknowledged the waiver. *

Yes No

Parish Team

Are you registering a parish team for the "Parish Challenge"?

Parish Team Name

Please give your parish name.

Parish Team City

Please give the city and state of your parish.

Where did you hear about us?

If other please indicate in "comments". Thank you this helps us make our marketing better next year.

Comment

I will pay credit card processing fee ($3)

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Coupon

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Credit Card Number*

Expiration Date*

Card (CVV) Code*

Card Type*

Card Holder Name*

Verification code*

Rosary Run Registration Page

Payment for Runner Registration