Empowerment 2K Run / Walk for Kids - Runner Registration Form

Information with an asterisk ( * ) is required to complete the form.

Name of Child: *
Name of School: *
By checking this box, I agree to the terms and conditions as outlined on ICB’s Waiver and Release form. *
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Please type the text displayed in the image. This will ensure that you are not a computer. Please use lower-case letters. *
I.C.B. • PO Box 9782 • Houston, Texas 77213
(713) 396-0245 | info@communitybuilders.me
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