Friday, July 14, 2000 -- Crabtree, PA
Mt. Carmel 5K Run and 2-Mile Walk

Click here to return to the Details Page

Waiver: In consideration of the acceptance of this entry, I waive myself, my heirs, and all claims for damages, which I might have against the race, it's sponsors, or any other organization, business, or individuals as a result of any and all injuries, which might be received during the contest. I also release any photo that may involve myself. I attest and verify that I am physically fit and have trained sufficiently for this event.

SIGNED: __________________________________________

(parent if under 18): ____________________________


PRINT NAME: _______________________  PHONE: ________________

ADDRESS: _________________________________

CITY: _______________________ STATE: _______ ZIP: __________

BIRTHDATE: __________________ AGE (day of race): ___________

CIRCLE SEX:  M  F

St. Bartholomew Parishioner: ______________________

FIREMAN: ________  FIRE DEPARTMENT: _______________

RUN: ___  WALK: ___   SHIRT SIZE:  M  L  XL  XXL

Make checks payable to:
Mt. Carmel Festival

Mail to:
Mt. Carmel Races
c/o St. Bartholomew
P.O. BOX A
Crabtree, PA 15624