Scholarship Run Registration Form

I release Wilson Community College and Foundation, its staff, directors, and agents from all liability for any injury or damage connected in any way whatsoever to participation in this event. I authorize the staff of the College, or appropriate medical personnel, to administer emergency medical treatment to my child or me. I also understand that I am solely responsible for all costs incurred as a result of such medical treatment. Furthermore, I agree and grant permission to the College to use photographs or video of my child or me in College brochures, flyers, photo collections, and other marketing initiatives.

*If you are a sponsored registrant, please list sponsor:

Note: To pay with a credit card, for security purposes, please call the Wilson Community College Foundation office at 252-246-1452 or 252-246-1293 to provide card information.

Questions: jelliott@wilsoncc.edu
252-246-1452 / 252-246-1293
Or visit our office, C-107 on the WCC Campus
Federal Tax ID # 58-1436911

Please make checks payable to:
Wilson Community College Foundation
902 Herring Avenue / P.O. Box 4305
Wilson, NC 27893

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902 Herring Avenue
Wilson, NC 27893
Phone: 252-291-1195

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Lee Technology Center

4815 Ward Blvd
Wilson, NC 27893

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Coastal Plains Law Enforcement Training Center

3997 Ward Blvd
Wilson, NC 27893

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