Chick's Run

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In Memory Of

Self Help
Center Inc.

Chicks Run History

Registration Form

Chick's Run 2008 - Registration Form

$40.00 - Early Registration (by May 15th) $50.00 - Late Registration
It is never too late to register
You can even register at the run!
$20.00 Fee on Returned Checks

Late registrants, please keep in mind that you are not guaranteed a T-shirt the
weekend of the run. We will be happy to mail them to you at an additional $5.00 postage.

Registrations Are Non Refundable

Name:
Address:
City:	State:	Zip:
Phone #:	E-Mail:

Free T-Shirt Included in Registration Shirt Sizes: S M L XL XXL(Circle)

Additional T-Shirts: $15.00 QTY:_____ Size: S M L XL XXL

Make Checks Payable to:	Chick's Run

Mail Check or Money Order and this form too:	Mail to: Chicks Run HC 74 Box 14 Cody, NE 69211

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