GRC Walk With Friends
Event Timing: Friday, September 3, 2021 @ 6:15 p.m.
Event Address: 1 Depot Street, Winchester, KY 40391(across the street from the Post Office)
Contact us at 859-351-8476 or dena@caudillcpa.com
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Complete One Form for Each Participant
Pre-Registration $15.00, Day of Registration $20.00
*A portion of the proceeds will benefit out local NAMI*
Last Name *
First Name *
Phone Number
Date of Birth
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Age as of 08/31/2021
Mailing Address
T-Shirt Size:  Only Check One Size *
Required
Application Waiver: I waive all claims for myself (for minor child) against the GRC Cheerleaders for any injury that may occur while participating in the Walk with Friends.  To accept type name below:
Date Signed
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Mail Payment to: (place name in memo line of check)
Payable to GRC Cheerleaders, Walk with Friends, 553 Earlymeade Dr, Winchester, KY 40391

You may pay at the Walk but in order to have a T-shirt you must pre-register.
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