To register for the 2nd Annual Heritage 5K, you may register in person at the Heritage Center, located at the corner of Bowman and High Streets in Dayton, VA.

To register on-line, please provide the following information:

Your Name:

E-mail Address:

Phone Number:

Street Address:

City:

State:

Zip Code:

Age at date of race:

Are you?

	Running	Walking

T-Shirt Size:

Youth Large	Adult Small	Adult Medium	Adult Large	Adult XL	Adult XXL

Check or
Credit Card:

	Check (by mail)	Credit Card (through bookstore)

Comments:

For questions, please e-mail Dale Harter dharter@bridgewater.edu

Mail checks to:

Harrisonburg-Rockingham Historical Society
PO Box 716
Dayton, VA 22821