Race Location Old Central State Hosptial 620 Broad Street Milledgeville, Ga
Mail Form + Check To FundRacers LLC 2217 Independence Lane Buford, GA 30519
___________________________________ First Name
_________________________________ Last Name
Gender: Male Female
Age (on 10/16/2026): ______
Registration:
5K T-shirt included $40.00
5K No T-shirt $25.00
T-shirt Only (no 5K) $25.00
Zombie (MUST BE A ZTA) $8.00
Select which option you'd like 1) Just 5K or 2) 5K with T-shirt or 3) just the T-shirt.
T-Shirt Size:
Youth SM
Youth MED
Youth LG
SM
MED
LG
XL
2XL add $2.00
No Shirt option
Choose one.
ZTA Sister who referred you:
______________________________
Type the name of the ZTA Sister who referred you to the event.
Additional Donation:
ZTA Foundation Donation ($5) $5.00
ZTA Foundation Donation ($10) $10.00
ZTA Foundation Donation ($15) $15.00
ZTA Foundation Donation ($25) $25.00
Would you like to make an additional donation to the Zeta Foundation supporting Breast Cancer education and awareness?.
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