Registration Form

TURKEY TROT FOR ST. JUDE

PRE-REGISTRATION FORM

November 12, Starting at Rigby High School Track

Participant Information

First Name ________________________________

Last Name_________________________________

Address (Line 1):_____________________________________________

Address (Line 2):_________________________ Apt _____________

City: ___________________________________

State: __________________________________

Country: ________________________________

Zip/Postal Code: __________________________

Home Phone: (______)_____________________

Day Phone:     (______)______________________

E-mail Address: _____________________________________

Payment Information

5K run/walk - $15

Kids race - $5

(CHECK BOX FOR RACE)

Make check payable to: St. Jude Children Research Hospital or pay online at raceforstjude.blogspot.com.

For more information visit: raceforstjude.blogspot.com