1. Colonial Heights Baptist Church
2013 Hearts of Compassion Family 5K & Fun Run
Run to Share Hope with the Hopeless
SATURDAY, NOVEMBER 2, 2013
Colonial Heights Baptist Church
444 Northpark Drive, Ridgeland, MS
REGISTRATION / PACKET PICK-UP: RACE START TIMES:
Friday, November 1 3:00 – 7:00 PM 5K Run/Walk: 8:00 AM
Saturday, November 2 7:00 – 7:45 AM 1 Mile Fun Run: 9:00 AM
REGISTRATION FORM
Mail Registration Form to: Colonial Heights Baptist Church, 444 Northpark Drive, Ridgeland, MS 39157.
Or Register in Person between 8:00 AM & 4:00 PM, M - F. For More Information, call 601.956.5000.
Name ____________________________________________________________________ Gender: M / F
Address ______________________________________________________ Age on Race Day: __________
_________________________________________________________ Phone:___________________
Email ___________________________________________________________________________________
FEE SCHEDULE: Please make checks payable to Colonial Heights Baptist Church.
5K Run/Walk: $25 through November 1. $30 on November 2.
1-Mile Fun Run: $20 (12 & under), $25 on November 2.
Family Registration: $70 max (individual forms turned in together) through November 1.
$75 max on November 2.
CIRCLE EVENT: 5K Run 5K Walk 1-Mile Fun Run (12 & under)
CIRCLE T-SHIRTH SIZE: T-shirt guaranteed for participants registered by October 14.
Youth S M L Adult S M L XL XXL (add $3)
Are you active in a local church? Y / N If so, where? ___________________________________
In consideration of the foregoing event, I for myself, my executor, administrator, and assignor do
hereby release and discharge the sponsors of the Hearts of Compassion Family 5K and Fun Run from
all claims arising from this participation in the above-named event. I am physically fit and have properly
trained to participate in this event. If under the age of 18, please have the guardian sign.
Signature_________________________________________________________ Date___________________