Name *

First Name

Last Name

Building Name or Location *

Only Family Members & Retirees Should Choose "Texins"

DMOS 5

DMOS 6

Kilby East

Kilby West

Research East

Research West

RFAB

SC Building

South Building

South Campus (Forest Lane)

Texins - Family Memberships & Retirees

Which race option will you participate in? *

1 Mile

5K

The St. Paddy's Run is free to participate. A lunch /t-shirt combination is optional, but available to purchase for $17. The deadline for purchasing this combo is Friday, March 7. *

Yes, Payroll Deduction (TI Employees). I would like to purchase the lunch option through payroll deduction. By selecting this option you are authorizing Texins to proceed with the $17 payroll deduction charge.

Yes, Credit Card. Please provide credit card payment at the front desk at Texins Fitness Center by Tuesday, March 11. If payment is not provided by the deadline you will not receive a lunch.

No thank you.

Please select your shirt size: (If applicable) *

If no shirt is being purchased please choose n/a

Small

Medium

Large

XL

XXL

n/a

Please select the type of sandwich you prefer: (If applicable) *

Turkey

Vegetarian

N/A

Do you want to receive future communications on Texins events?

Yes

No