Registration Forms

Please select and print from the following forms below to complete your registration. You may either drop off these forms at West Central Insurance, located at 815 W. Clinton in Rushville, IL (inside the West Central Bank building) or mail these to 5K Walk, P.O. Box 44, Rushville, IL 62681 by October 11th, 2011.

Pledge Form

Waiver Form

Tax Receipt

Money Procedures

 

All forms formatted for Adobe Acrobat Reader (PDF)