Rodney Battles 5K Sign Up Form

Race Date: September 6, 2025

Location: Commerce Bank parking lot
Check-in: Starting at 6:30 AM
Start Time: 7:00 AM

Cost: $35 - Includes T-Shirt
Participant Information

Please fill in your information below.
Full Name*

First NameLast Name
Age*
Gender*
Email*
example@example.com
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
XSSMLXLXXL
Do you have additional runners?*
If you choose yes, please add their name, age, gender and shirt size in the box below.
Additional Runners Information
Emergency Contact Details
Contact Person*

First NameLast Name
Phone Number*

Area CodePhone Number
Relationship*
Payment Information

We accept cash, check, or PayPal! Cash can be dropped at Commerce Bank. Checks made out to Tipton Chamber of Commerce, dropped at Commerce Bank or PO Box N.
Method of Payment*
Should be Empty: