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2013 ora registration.doc

2013 ora registration.doc

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Published by antwerpvillage
5k/10k run walk, 1 mile walk
registration form
5k/10k run walk, 1 mile walk
registration form

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Published by: antwerpvillage on Mar 06, 2013
Copyright:Attribution Non-commercial

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08/21/2013

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3
rd
Annual “Operation Restore Antwerp”Redneck Run/Walk 
Saturday, August 3rd, 2013Antwerp, New York 
Come Help us Restore Antwerp
!Future Plans: Play Ground for the Ball Park, Historical Preservations, CommunityRestoration, and Positive Community Environment.Registration forms may be accessed at:http://www.facebook.com/OperationRestoreAntwerpOrhttp://villageofantwerp.net/homePlease make checks payable to: OLD HOME DAY with “ORA” on the memo line To receive a FREE tee-shirt all forms must be received by June 30
th
 Mail Forms to: Karen SandsPO Box 661Antwerp NY 13608In person registration will take place at the Antwerp American Legion on:
 
Friday, August 2rd from 6:00 – 8:00 pmSaturday, August 3
th
from 7:30 – 8:45 amAward Category
(
10K 
)- over all winners- Female/Male $100-1
st prize,
$50-2
nd prize
$25-3
rd prize
 (
5K 
) - over all winners- Female/Male $60-1
st prize,
$30-2
nd prize,
$15-3
rd prize,
 (
1M walk 
)
Best Dressed Redneck costume
- $50-1
st prize,
$25-2
nd prize
, $10-3
rd prize
Walkers, You have to wear the costume to win the prize…just sayin…
* Waiver must be signed to participate
 
Registration form for the 3rd Annual redneck walk/run
Last Name: ______________________ First Name:______________________ Race Day Age: ______ Gender________ Address: __________________________ City/Zip: _______________________________ Phone: ______________________________ Email: ______________________________ To receive free tee shirt registration must be received by June 30 ($20) 10k run or walk ($15) 5k run or walk ($10) 1 mile walk 
T shirt Youth YS YM YL Adult S M L XL XXL
Amount Paid: $ ______ 
Please make checks payable to:
OLD HOME DAY
with
“ORA”
on the memo line
Waiver must be signed to participate

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