Sunday, September 12, 2010 -- Helvetia, WV
Helvetia 10K Mountain Run, 2M Walk, Kids Fun Run
ENTRY FORM
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Early registration is $17 by Aug. 29 /$20 thereafter T shirt guaranteed, in size requested, to entries received by Aug 30 early registration date. There will be shirts available on a first come basis after that date.
There is no registration fee for the Kid's Fun Run, however a T shirt may be purchased for $10.00
Please make checks payable to: Helvetia Fair Association
Mail entry forms to: Helvetia Mountain Run, P.O. Box 18, Helvetia, WV 26224
NAME:_______________________________________________________________ ADDRESS:____________________________________________________________ CITY:_______________________________________ STATE:_________________ ZIP CODE__________________ PHONE:___________________________________ E-MAIL:_____________________________________________________________ 10K RUN ____ // 2 MILE WALK ____ // KIDS RUN ____ FEMALE ____ or MALE ____ // AGE ON 9/12/10 ____ 100% Cotton SS Tee SIZE: S____ M____ L____ XL____
WAIVER: For and in consideration of my participation in the Helvetia 10K Mountain Run, the 2 Mile Walk or the Kid's Fun Run in Helvetia, WV, I, the undersigned, release forever the WV Mountain Trail Runners, Helvetia Fair Association, sponsors, the program, its members, volunteers, co-sponsors, landowners, race organizers, race directors, other participants and all those associated with the Helvetia 10K Mountain Run from any claim for harm, injury or loss that occurs to me or my child/ward or anyone on his/her behalf as a result of participation in this event. I therefore attest and verify that I am physically fit and have sufficiently trained for this event and am aware of the potential dangers.
SIGNATURE:___________________________________________________________
(PARENT/GUARDIAN IF UNDER 18)