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Mail-in Registration (postmarked by July 1)
Must be entirely completed
Last name __________________Â First name __________
Street ____________________________________ Apt. __
City ______________________________ State/Prov ____Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Zip ______Â Â Country ____________
Phone ___________Â e-mail _________________________
Emergency contact name ___________________________
Emergency contact phone __________________________
Please circle appropriate response
Gender:  Male    Female
Age: 12 & under   13-19   20-29                                  Â
         30-39    40-49  50-59   60+
Event: 10K Run  5K Run   5K Walk      Kids Fun Run
  * For walkers only. Please be respectful of other walkers by not running !
Cost: Adult - $16Â Â Â Youth (12 & under) or Senior (60+) - $5
          Family (children under 18) - $36Â
          Kids Fun Run - $5
T-Shirt: $10
  Adult sizes  S   M    L   XL  XXL Â
  Child sizes     M (10-12)    L (14-16)
Total enclosed $ _____Â Â Â Â Â Â Â No. family members ___ **Â
Payable to:Â Â Â Fairfax Parks & Recreation Dept.
Mail Registrations to:
Fairfax Egg Run
C/o Bonnie Waninger
791 Shaw Rd.
Cambridge, VT 05444
 Registration
Fri, July 31: 6:00 - 7:00 PMÂ Â Â Â Sat, Aug 1 : 7:45 - 8:30 AM
Location: Fairfax United Church,
Fletcher Rd. / River Rd. intersection (see map)
Cost: Adult - $20Â Â Â Youth (12 & under) or Senior (60+) - $6
          Family (children under 18) - $45
           Kids Fun Run $5
T-Shirt: $10 (limited sizes only; while supplies last)