Heron Lake-Okabena Community Foundation
3rd Annual Road Race

                                        Road Race Cost & Registration Form

$10 for pre-registration (received by August 6) and $15 after August 6th & day of the race.

Name of participant: ______________________________________________________

Address: __________________________  City:_________________  State:  _______  Zip__________

Age Division (please circle):  0-6   7-12   13-17   18-29   30-39   40-49   50-59   60 & older

Race (please circle):  1/2 mile kids run      1 mile walk/run      4 mile walk/run

T-Shirt Size (please circle):
Youth Sm (only available for pre-registration)       Youth Med.         Adult Sm.         Adult Med.     
            
Adult Large         Adult XL

Send registration and payment to:  SSC HS, % Becky Cselovszki,  124 N. Minnesota,  Box 97, 
Okabena,  MN  56161.  If you have questions, please call (507-360-4333. 

Make Check Payable to the HLOCF.