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Kiwanis Oktoberfest
Scarecrow Scamper 5K Application

Scarecrow Scamper 5K

Saturday, October 12, 2013

8:30 AM - Peace Park - East Dayton Street, West Alexandria

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First Name _______________________   Last Name_______________________________________________
 
Address_________________________________________________________________________________
 
City _____________________________________________   State_________   Zip__________________
 
E-Mail Address___________________________________________________        Circle Gender:  M  or  F
 
Circle T-Shirt Size:      YS      YL      S      M      L      XL      XXL
 
                                        Pre-Registration with Free T-Shirt guarantee before 9/20  -  $20
 
                                           Later or same day Registration  $25  
 
                                                           Pre-race Check-in beginning at 7:30 AM
 
Make checks payable to:  TVS CBI               Questions? - call Robin Judd  937-839-4693
 
Mail Checks & Registration to:
Robin Judd
Twin Valley South HS
100 Education Drive
West Alexandria, OH  45381
 
                                                  Additional Information Available At:    www.alliancerunning.com
 
                                                      Proceeds Benefit TVS Career-Based Intervention Program