Miracle Deliverance Temple of Christ
Thursday, October 08, 2015

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        
 City    State     
Office Phone          
Other Phone 
Running          Walking      Wheel Chair               Other      
Registration Fee: 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 but recommended to promote unity among the participants
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