Any Questions
Contact Information:
Brandon Evans
Phone: (740) 971-9338
email: isaac.0711@yahoo.com
Radnor Baptist Church
4050 Radnor Rd
Radnor, OH 43066
(740) 595-3462
Name :_______________________________________
Address:______________________________________________
City:_____________________ State:________ Zip:_______________
Phone: ___________________ T-shirt S M L XL E-Mail-_________________________________
5k run or 5k walk Age_______ Male Female
Signature:_________________________________________
Waiver: In consideration of the acceptance of the entry, I wave for myself and my heirs all claims for damages against the
Radnor Baptist Church 5k and their representatives and all race officials and volunteers for injuries
during and as a result of this event. If I should suffer injjury or illness, autherize officials of the race to use their discretion to have me treated and transported to a medical facility, and I take full responsibility for this action. I certify that I am physically fit and have sufficiently prepared myself for this event. No in-line skates do to rough road surface and finish on grass.
Please print; fill out, and mail in to 4050 Radnor Rd Radnor, OH
43066
Cost: $15