Westhampton Hills 5K Run/Walk Registration

Please mail your registration form to: Westhampton Hills 5K, Westhampton Public Library,

1 North Road, Westhampton, MA 01027 

Race Fee: $10 donation

PLEASE DO NOT MAIL THIS FORM AFTER OCTOBER 16, 2013 REGISTER ON SITE. 

Last Name ________________________________________ First Name ___________________________________ 

Street Address ___________________________________________________________________________________

City __________________________________________________ State _______ Zip __________________________

E Mail Address ______________________________________________ Phone: ____________________________

Gender:   M    F     Age as of 10/20/13: _____________               5K Run _____    2 Mile Walk _____

[ OFFICIAL USE ONLY - Bib #______________        FEE PAID:    Y      N  ]