WARDENSVILLE SCHOLARSHIP
                             FUND ASSOCIATION (WSFA)
                                    5K/10K RUN
                               SEPTEMBER 24, 2011
                           WARDENSVILLE COMMUNITY CENTER


                INDIVIDUAL RUNNER REGISTRATION REQUIRED INFORMATION:



Name of Runner________________________________________Age on Race Day________

Event you are entering:   5K Run________ 10K Run______ 

Mailing Address______________________________________________________________

City/State/Zip___________________________________Home Phone___________________

Email address________________________________________________________________

Military:    Active____________    Retired___________   

High School Student____________

T Shirt with pre-registration for 5K/10K Runners/Walkers

Check your size YM______ YL______  AS_______ AM_______ AL______  AXL _______

5K and 10K entry fee: $15.00
Student and Military entry fee: $10.00

Please make checks payable to:  WSFA
			        P.O. Box 652
                                Wardensville, WV 26851

For Further information please call Robin Kane 304-874-4073 or 
Email:     RobinKane@msn.com