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Kiwanis Oktoberfest
Scarecrow Scamper 5K Application

Scarecrow Scamper 5K

Saturday, October 11, 2014  8:30 AM - Peace Park - East Dayton Street, West Alexandria



First Name _______________________   Last Name_______________________________________________
City _____________________________________________   State_________   Zip__________________
E-Mail Address___________________________________________        Circle Gender:  M  or  F          Race:  5K  or 10K
Age on Race Day ______          Circle T-Shirt Size:      YS      YL      S      M      L      XL      XXL          Colors may very.
Pre-Registration with Free T-Shirt  $20                Same day Registration  $25  
Over-All Winner & Male/Female Age Groups  1st, 2nd, 3rd, Place Awards
Pre-race Check-in beginning at 7:30 AM
Questions?  Contact Robin Judd, CBI Coordinator:  937-839-4693,  rjudd@tvs.k12.oh.us
Electronic Registration:  www.alliancerunning.com
Mail-In Registration with check payment to:  TVS CBI
Mrss. Robin Judd
Twin Valley South HS
100 Education Drive
West Alexandria, OH  45381
All proceeds benefit the sudents enrolled in the
Career-Based Intervention Program at Twin Valley South High School