2010
TURKEY TROT REGISTRATION FORM
PLEASE PRINT THIS PAGE AND MAIL OR FAX TO ADDRESS BELOW
NAME:______________________________________________________________________________________________________________
ADDRESS:__________________________________________________________________________________________________________
CITY/STATE/ZIP:_____________________________________________________________________________________________________
Elementary School Student/List School:____________________________________________________________________________________
ENTRY FEE - FREE WILL OFFERING
FOR $25.00 DONATION: T-SHIRT SIZE: XL L M S
NOTE: Family members receive a T-Shirt for each subsequent $10.00 donation.
A family of three can receive three T-Shirts for a $45.00 donation.
All checks should be made out to "2010 TURKEY TROT"
For Official Use Only:
Mail T-shirt to the following address: ____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Pre-Registration:
Mail this form to:
Turkey Trot
ATTN: Darrell Lovell
100 S. Main Street
Henderson, KY. 42420
OR FAX to: 2708260053
E-mail address: dlovell@ohiovalleyfg.com
NOTE: The Presbyterian Church of Henderson and Corporate Contributors associated with this event are not liable for any injury, illness or damage which may result from participation in this event. I agree to hold any organization or any person affiliated with the Turkey Trot event, harmless of injury, illness or damages which may result form my participation.
SIGNATURE:_________________________________________________________________ DATE:_____________________
