Miracle Deliverance Temple of Christ
Thursday, October 30, 2014

Run For Jesus Registration

 
                            Run For Jesus 2014
                    Miracle Deliverance Temple of Christ, Inc. 
                    3402 Doris Circle, Montgomery, AL 36105
                         (334) 265-6935  Fax (334) 262-5669
 

Participant's Name        
 
Address                    
 
 City    State     
 
 Zip
 
Office Phone          
 
Other Phone 
 
Running          Walking      Wheel Chair               Other      
 
Registration Fee:          Presenter     $25.00          Adult Participant     $15.00        
Children Under 12 yrs. Old     $10.00     
 
How many people are you registering for?      
Total Payment   
Paying by Check? Please complete, print and mail this form with your check to the above address.
Make checks payable to MDTOC C/O Run for Jesus or click on the Donate button below.            
 
__________________________________________________________________________________________________________________________
 
                                                  T-Shirt Order Form
T-Shirts are optional. Ordering deadline is July 24th for T-Shirts.
 
Place the number of t-shirts you are ordering in the blank next to the size indicated below:
Small  Medium    Large    XL    XXL 
 
Size Amounts:
Small – XL = $12.00    XXL – Larger = $15.00
How many T-Shirts are you ordering?  Total Payment