Please fill out
a separate form for each family member-
Male
Female
________________________________________________________________
First name (Please Print) === Last Name ===
Age
Address =
City / State/ Zip / Phone # / Email =
I will participate in the following event:
$15.00 per entry received before 05-15-2011
5k Run
5k Walk
T-Shirt Size: Adult
Small XL
Medium XXL
Large
T-Shirt Size: Youth
Small
Medium
Large
Waiver and Release Statement
5k fun run/walk (All participants must read
and sign)
I have read the accompanying event
information and understand the policies of the event. I know
that running and walking a trail race is a potentially
hazardous activity. I should not enter unless I am medically
able. I assume all risks associated with my voluntary
participation in this event.
Sign_____________________________________________________________________