Sponsored by
Peterborough Regional Vascular Health Network
Race Date: Sunday, February 24, 2008
1) Fill in information , 2) Print this page 3) Sign & date at bottom, and 4) Mail registration to:
Attn: Race Registry, YMCA of Peterborough, 123 Aylmer Street S,
Peterborough, ON K9J 3H8
Please ensure the information is completed and accurate. We cannot be responsible for errors made that may affect timing or prizes.
Last Name:
First Name:
Address:
Apt#:
City:
Province:
Postal Code:
Telephone:
Sex:
Female
Male
Age:
E-mail Address:
Club Name:
Registration Costs: |
Half-Marathon | 5K | 1K |
| Now to January 13th | $40.00 | $25.00 | $15.00 |
| January 14th to February 12th | $45.00 | $30.00 | $15.00 |
| February 13th to 24th | $55.00 | $35.00 | $20.00 |
Cheque Enclosed
MasterCard
Visa
Name on Credit Card:
Card #:
Expiry Date:
Cardholder's Signature:
Signature Date