Check
here if you will need childcare during the race ____# of children ____ agesIf you have adobe acrobat reader©, click here, otherwise print out this web page for your reg. form
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Early Entry: $18 by May 10th May 11th through race day $25 |
Official Entry Form Please fill out this form completely. Incomplete and illegible forms will not be accepted and will not be entered in the race. |
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Mail to: Grandin Court Baptist Church 2660 Brambleton Ave. SW, Roanoke, VA 24015-4306
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Waiver: In consideration of being permitted to participate in the Grandin Court 5K, I do hereby for me, my heirs, executors, administrators, and assignees, release and forever discharge the sponsors and all those persons involved in organizing and manning this event from all claims, demands, loss, damage, actions, causes of actions or suits as long or inequity of whatsoever kind of nature arising out of my participation in the race on May 17, 2007. |
| First Name | Initial | Last Name | |||
| Street Address | City | State | Zip | ||
| Phone Number Age Birthdate | |||||
| Sex Male or Female (circle one) T-Shirt Size (circle one) S M L XL | |||||
| Signature **** Parent or guardian must sign if participant is under 18 years of age*** | |||||
Check
here if you will need childcare during the race ____# of children ____ ages
Print out registration form and mail to the church to be officially registered.
Call or email if you have any questions, 774-1684 ext.1 4 or youth@grandincourtbaptist.org