Manna - The 12th Annual Manna 5K Fun Run/Walk Registration

The 12th Annual Manna 5K Fun Run/Walk Registration

Thank you for registering for the 12th Annual Manna 5K Fun Run/Walk on March 27, 2010. Adults are $25 each and Youth and Seniors are $15. Please be sure to include age and gender information for each person you are entering.

First Name

Last Name

Gender

Age Group

Address

Address
(cont'd)

City

State Zip *

Daytime Phone

Other Guest Registrants (Please select Gender and Age Group)
First Name	Last Name	Gender	Age Group

I would like to reserve:

Adult Registration - Adult(s)- $25

Youth and Senior Registration - Youth & Seniors(s)-$15 (18 and under;65 and over)

Please add a donation of $ to my total amount.

Total amount due $

I am not able to attend, but wish to support Manna's programs and services. Please accept my tax-deductible contribution in the amount of $

Note: You will be taken to PayPal to provide credit card information upon submission of this form.