All participants Must Complete and sign this form.

Make checks payable to: Upper Deerfield Schools

Send check & Entry Forms to:

For more information please contact: Julia Walton at (856) 455-2267 x 3215

Full Name _____________________________________________

Street Address __________________________________________

City _______________________________ State ____ Zip Code _________

Age ______ Sex ____ Shirt Size  M __ L __  XL ___

5k Run _____   1 Mile Run ____   Both races ____

Race fee: $ ___________

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