5K Run to the Corn - Sign up: 7:30a.m. - Race Starts - 8a.m. Sign Up and race starts is in front of the First Baptist
Church on Mitcham St.
Sponsored by Brookshires of Malakoff & The Malakoff Rotary Club
Name:__________________________________________________________________________________________________________________________
Address:________________________________________________________________________________________________________________________
Phone#_______________________________e-mail:__________________________________________________________________________________
Age
on April 7, 2012__________________________ Male:____________ Female:___________
T-Shirt
Size: Adults __________S _________M ________L ___________XL
Kids:
___________YM _____________YL
Catagories: 14 & Under, 15-16, 17-19, 20-29,
30-39, 40-49, 50-59, 60-69, 70 and over. In the above age groups, men and women will
receive awards and will
be eligible for door prizes.
ENTRY FEE: $15.00 if paid by April 7, 2012 - $20.00 day of sign-up
In
consideration of my signed entry, I waive my rights and claims to damages against the sponsors and producers of this event.
I attest
I am physically fit and I understand the fees are non-refundable. This entry is invalid unless signed
by entrant. If entrant is under 18 years of age, parent
or guardian must sign entry. One entry per form,
copies accepted.
Signed:__________________________________________________________________________
Date:________________________________
Parent/Guardian Signature:______________________________________________________________________________________________
