Plumpynut 5K Registration

Please complete this form to register. You can either mail your registration fee or bring it with you that day.

Name:
Address:
City:
Zip:
Email Address:
Phone Number:
Gender:	Male Female
Date of Birth:
T-Shirt Size:	YS YM S M L XL XXL
Run:	5K 100m (You may run both with one entry fee)
	By submitting your registration you and your heirs release and hold harmless Truth Community Church and all sponsors and associates of this event in care of injury. You realize that running/walking in a road race is potentially hazardous. You further state that you are of sound mind and body and are in sufficient physical condition to participate.