Saturday, August 7, 1999 -- Nutter Fort
WV Blackberry Festival 5K Run

SEND AS SOON AS POSSIBLE!!!

Please make checks payable to: WV Blackberry Festival

Mail entry forms to:
WV Blackberry Festival 5K Run
213 Indiana Avenue
Nutter Fort, WV 26301

Click here to return to the race Details Page

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NAME:_____________________________________________________


ADDRESS:__________________________________________________


CITY:_______________________________STATE:____ZIP:________


PHONE:____________________________________________________


AGE ON RACE DAY:______   MALE:______   FEMALE:_______ 

T-SHIRT SIZE:  XXL____  XL____  L_____  M_____

(First 50 pre registered by July 30th will receive a T-shirt)  

WAIVER: My signature below releases all persons connected with this event from all liabilities in any form or circumstances from me or any representative(s).

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SIGNATURE                                     DATE

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PARENT OR GUARDIAN SIGNATURE IF UNDER 18

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(PLEASE PRINT) PARENT OR GUARDIAN NAME