Wednesday, July 12, 2000 -- Connellsville, PA
18th Annual John Woodruff 5K Run & Walk

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Make checks payable to:
John Woodruff Club
706 Blackstone Avenue
Connellsville, PA 15425

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ENTRY FORM

(please print)

NAME: __________________________________________________

ADDRESS: _______________________________________________

CITY: _____________________ STATE: ____ ZIP: ___________

AGE (on race day): _____  DATE OF BIRTH: _______________

PHONE: ________________________   

MALE   FEMALE           T-SHIRT SIZE:  S  M  L  XL

RACE SELECTION:   5K RUN   WALK

In signing this entry, I hereby release The John Woodruff 5K Race and Walk from any claims or responsibility for any injuries suffered by me in this event.

Signature: ______________________________________________
(if under 18, parent or guardian must sign)

Entry not valid unless all information herewithin is filled out and signed.