2011 Run for Rita Signup

---

Please use this form to sign up for the 5th annual Run for Rita. You may include up to 4 total people per form, if you have more than 4 please submit a 2nd form. I will be responding to each person who submits the form with a verification that I have gotten your info, I will do this as soon as possible, if it you do not receive notification within about 1 day of submitting the form. If you have any problems with the form email me at cnssone@yahoo.com

Registration fee including tshirt is $20 per adult and $10 per child, payable at the run.

Make sure you press submit when you have finished the form.

First Name

Last Name

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Home Phone

E-mail

Please select your tshirt size below, also any additional people in your household would like to signup, up to 4 per form

1st Tshirt none Child X-Small Child Small Child Med Child Large Adult Small Adult Med Adult Large Adult XL Adult XXL

2nd Person

2nd Tshirt none Child X-Small Child Small Child Med Child Large Adult Small Adult Med Adult Large Adult XL Adult XXL

3rd Person

3rd Tshirt none Child X-Small Child Small Child Med Child Large Adult Small Adult Med Adult Large Adult XL Adult XXL

4th Person

4th Tshirt none Child X-Small Child Small Child Med Child Large Adult Small Adult Med Adult Large Adult XL Adult XXL

---

Run For Rita

www.run4rita.org

email cnssone@yahoo.com