Day, Month Date, 2008 at Time A.M.
Race Name Distance Mile Run/Walk
Place Name Address, City, and State zip

Race Information: Be sure to give the full street address of your race
so people may look up a map at Google or MapQuest. Sometimes it is
near impossible to find a place name without a street address and you need
a street address to use on-line map services.

Registration and Packet Pick-up Information: It is good to use services such as Get Me Registered and Active.com but be sure to list the exact page your race is on or people may not be able to find it particularly at Active.com. Also put where to pick up packets.

Course Description: flat and fast put where the course starts and finishes

Facilities: Packet pick-up, registration, restrooms will be at

Awards: Overall Male/Female, Masters Male/Female awarded.

Additional Information: a phone number and/or email address should be here

____________________________________________________________________

Mail Entry Form and make Checks payable to: address city state zip

Name: ____________________________ Age: _____ Sex: ____ Phone: ________

Address: ___________________ City: ______________ State: ____ Zip_______

Check one Run: _____ Walk: ______

Waiver: I know that running a road race is a potentially hazardous activity.
I should not enter unless I am medically able and properly trained. I assume all risks
associated with running this event. Having read this waiver and knowing these facts and in
consideration of your accepting my entry fee, I, for myself, and anyone entitled to act on my
behalf, waive and release the Running Club, City, The Parks and Recreation Board, and
all sponsors, their representatives and successors, for all claims or liabilities of any kind
arising out of my participation in this event.

________________________________________ ___________________________________
Signature (Parent’s Signature If under 18) Date