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 on/before
9/6 - $20
Later or same day Registration $25 Purchase T-Shirts $10
Pre-race Check-in beginning at 7:30 AM
Make checks payable to: Twin Valley South
Questions? - call Robin Judd 937-839-4693
Mail Checks & Registration to:
Robin Judd
Twin Valley South HS
100 Education Drive
West Alexandria, OH 45381
Proceeds
Benefit TVS Career-Based Intervention Program
