Rollie Run 2008 Registration Form

Name:
Address:
City:
State: Zip:
Phone:
Age:
E-Mail:
Shirt Size:

Childrens: Small Medium Large
Adult: Small Medium Large
XL XXL
Payment Type:

PayPal Check
 

Paying by check? Please make payable to: "Rollie Run"
Submit this registration form and send or deliver to:

Mail to:
heartandsoul
PO BOX  787
Holland OH 43528

Deliver to:
Providence Lutheran Church or
Springfield Twp. Maintenance Building

Choose One:

Team Sponsorship: A team of 5 or more can register for $20 per person. Please specify the number of people in your team in the comments section below.

Comments:

By submitting this form, you agree to be charged the requested amount to the credit card specified. If you are paying a sponsorship by check, you are under a good faith agreement to bring the registration of $25 to the sign in table the morning of the run. We appreciate your generosity. And we thank you for participating in the Rollie Run! Questions?


Design by Winged Design