Merrill King Registration Form
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Transcript of Merrill King Registration Form
Merrill King’s Fit 4 Fall 5K & 1-Mile Fun Run
Merrill King’s Fit 4 Fall 5K and 1 Mile Fun Run will be held in honor of Merrill King, a victim of childhood cancer. Participants can run
the 5K or take their families for a fun jog in the 1 Mile Fun Run.
Saturday, August 14th Registration begins at 6AM, Race will start at 8 AM
Where: Roswell High School - 11595 King Road, Roswell, GA 30075
Cost: $20 donation to run, $25 (After August 12)
About Merrill: Active in many sports, Merrill King loved to run and play soccer.
She was diagnosed with Leukemia in April of 2004, but fought the disease for four years before she relapsed in 2008. Sadly, Merrill passed away in February 2010,
but her legacy lives on.
Merrill King’s Fit 4 Fall 5K & Fun Run Registration Form
Name: ___________________________ Birthdate: _____________ Gender: ________
Address: _________________________________________________________________
City, State, Zip: ___________________________________________________________
Email Address: _____________________________ Phone: __________________
Race: □ 5K □ Fun Run Phantom Runner?: □ Y □ N
T-shirt Size (circle one): YS YM YL YXL S M L XL XXL
Payment Information: I wish to pay by check or cash I wish to pay by credit card (See below)
Name on Card Billing Phone Number
Billing Address Billing City, State, Zip
Credit Card Number Expiration Date CVV Code
Name (Please Print) Signature
Note: Please make checks payable to Rally Foundation
Memo: Merrill King 5K (Required) Mail your registration to: Rally Foundation, 5775 Glenridge Drive, Building C, Suite 120,
Sandy Springs, GA 30328. Questions? Call Donna Cobb (404) 840-6798