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 10, 2014 - REGISTER ON SITE. 

Last Name ___________________________________ First Name ________________________________

Street Address ___________________________________________________________________________

City __________________________________________ State _______ Zip __________________________

E Mail Address ____________________________________________ Phone: _______________________

Gender:   M    F     Age as of 10/19/14: _____________               5K Run _____    2 Mile Walk _____

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