Cancer to 5K Enrollment

Cancer to Crushing It Enrollment

Thank you for your payment. To complete your registration for the Cancer to Crushing It virtual 5K training program, running from April 22-June 8, please complete this form.

If you are completing this form after the 10 spots have been filled, you will be added to the cohort waitlist.

Name(Required)

First Last

Email(Required)

Phone(Required)

Date of Birth(Required)

Time Zone(Required)

T-Shirt Size(Required)

Mailing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Please share a sentence or two about your cancer journey. When were you diagnosed? What type of cancer?(Required)

Releases

Photo Release: I agree that my name and photo may be shared on Livestrong's website, social media, and promotions.(Required)

Agree

I have consulted my physician about this exercise program and they encouraged me to proceed.(Required)

Agree

I intend to complete the Cancer to 5K program.(Required)

Agree

Livestrong may share my email and phone number with my cohort of Cancer to 5K teammates.(Required)

Agree

My Cancer to 5K trainer can text me.(Required)

Agree

I will download the Strava app to track my progress and connect with teammates.(Required)

Agree

Who is your Cheerleader? Please share one person who will be supporting you throughout this process.

Your Cheerleader's Name

First Last

Your Cheerleader's Email

Your Cheerleader's Phone