Register for the Waterway Village 5k Run/Walk to be held on Saturday October 3, 2009 at 7:30am.
Proceeds to benefit the North Treasure Coast Chapter of the American Red Cross.
Registration deadline is September 26

Print and complete this form and mail with check payable to North Treasure Coast Chapter American Red Cross to:

North Treasure Coast Chapter American Red Cross
Attn: Waterway Village 5k Run/Walk
2506 17th Ave.
Vero Beach, FL  32960

If you prefer, you may register by phone, using a credit card, by calling (772) 562-2549.

Please print legibly

Name_________________________________   Sex_________   Race day age_______   T-shirt size:   S     M     L     XL

Street address_____________________________________   Email________________________________________

City & State_____________________________________________________   ZIP code________________________

Emergency contact name & phone number______________________________________________________________

Entry amount included $_______________   +Donation (if you wish) $_________________  Total $__________________