1. Jingle Bell 5K Registration

Kappa Alpha Theta Jingle Bell 5K Registration
Benefitting CASA at Woodlawn
Saturday, December 4th, 2010
Race Begins at 10 AM

Cost: $20/person
$15/Centre students and staff

Please answer the following questions to register for Kappa Alpha Theta's Jingle Bell 5K 2010.
All payments can be made to:

Kappa Alpha Theta
attn: Erika Larkin
600 West Walnut Street
Danville, KY 40422

Payments can also be made the morning of the race by cash or check only please!

Please contact Erika Larkin at Erika.Larkin@centre.edu if you have any questions.

Thankyou, see you December 4th!

* 1. Name:

* 2. Address (include City, State and Zip code):

* 3. Email Address:

* 4. Age:

* 5. Gender:

* 6. T-Shirt Size:

* 7. By checking this box you agree to the following statement:

I understand that running or walking in a race involves some risks. In checking this box, I agree to accept all responsibility for myself during the event.