Easter Seals 5K Walk & Run To… “Make the First Five Count” Saturday, April 25, 2015 Boardman Park, Boardman, Ohio Registration at 9:00 a.m. / Walk & Run at 9:30 a.m Lariccia Family Community Center 1 Mile/3K/5K Walk, Stroll, Roll or Run Registration $25 Per Participant Early-bird $20 by April 10, 2015 First 150 to pre-register receive an official event T-Shirt! Register TODAY! Call 330-599-5515 or visit www.mtc.easterseals.com Easter Seals Walk to “Make the First Five Count” Registration Form Saturday, April 25, 2015  Registration 9:00 a.m. Team Name:_____________________________________________________________________ First Name: _________________________ Last Name:________________________ Address: ________________________________________________________________________ City/State/Zip: ___________________________________________________________________ Phone: _________________________________ I am participating as:  an individual Email: ____________________________  on a team Does your company have a matching gifts program?  Yes  No Name of Company: ______________________________________________________________ Shirt Size: Youth: **First 150 to pre-register receive an official event T-shirt S M L Adult: S M L XL 2XL 3XL 1st Place Overall in 5K Race for Male and Female will receive $25.00 EACH! Awards for Top Two Places Male and Female in the following age groups: 14 & Under; 15-19; 20-29; 30-39; 40-49; 50-59; 60-69; 70 & Over Please mail form and checks payable to Easter Seals: Easter Seals and Youngstown Hearing & Speech Development Department 6614 Southern Boulevard Youngstown, Ohio 44512 or fax completed form to 330-726-9182 or register online at www.mtc.easterseals.com Thank you for your support!