2026 Rodney Battles 5K Sign Up Form

Race Date: September 12, 2026

Location: Tipton Fairgrounds
Check-in: Starting at 6:30 AM
Start Time: 7:00 AM

Cost: $30 - Includes T-Shirt
Participant Information

Please fill in your information below.
Full Name

First NameLast Name
Age
Gender
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
T-Shirt Size
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
Format: (000) 000-0000.
Relationship
Method of Payment
Venmo: tiptonmochamber
Payment Information

You can mail a check to: P.O. Box N Tipton, MO 65081 | Venmo: tiptonmochamber (Please add Rodney Shirt to description)
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