5K for School Supplies Entry Form

Address:_________________________________ City/State:____________________ Zip:_______________

Phone #:__________________________________Gender: Male/Female

Circle T-Shirt Size:

Youth Medium	Youth Large	Adult Small
Adult Medium	Adult Large	Adult X-Large

In consideration of this entry, I hereby release First Baptist Church for any and all injuries incurred to me or by me or any acts or omissions by any organization, or individual that take place at said race. I further certify that I am physically able to participate in this walk/run.

Signature of Participant:________________________________________ Date:_______________

Mail form with payment to:

FBC Women's Ministry

P.O. Box 403

Llano, TX 78643