Heather Hills FunFest 5k 2009

AUGUST 8, 2009 – 9:00 am - HEATHER HILLS BAPTIST CHURCH

LAST NAME: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|

FIRST NAME: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|

AGE: _____ SEX: M__ F__

STREET ADDRESS: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|

CITY: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__| STATE : |__|__|

ZIP: |__|__|__|__|__| PHONE#: (____)|__|__|__-__|__|__|__|

E-MAIL: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|

SHIRT SIZE: S___ M___ L___ XL___

Entry Fee: $10 if received by August 5 - $15 at the race

Mail entry with check payable to: Heather Hills 5k, 1421 N German Church Rd , Indianapolis IN 46229

Church Phone (317)894-7474 e-mail questions: Brian09@DINOseries.com