Family Services Incorporated

First Name:
Last Name:
Street Address:

City:
State:
Zip:
Phone:
Email:
Gender:	Male Female
Age: (at the day of the race)

Event: ($1.00 processing fee will be added to each entry)	10K Run ($20 Entry Fee) 5K Run ($20 Entry Fee) 5K Fun Walk ($20 Entry Fee) Lollipop Race ($10 Entry Fee)

T-Shirt Size:	M L XL XXL Youth

	After receiving your online registration, Family Services will contact you by phone to confirm your registration and to take your credit card information.