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Wednesday, August 16, 2000 -- Connellsville, PA
Phil Foley Walk/Run
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Make check payable to and mail entry to:
A.G. Montessori School
199 Edison Street
Uniontown, PA 15401
Name:__________________________________________________
Male:_____ Female:_____ AGE (as of 8-16-2000):_______
Phone # (_____) _____ - ________
Street Address:________________________________________
City:_____________________ State:_____ ZIP:__________
Adult Shirt: SM___ MED___ LG___ X-LG___ XX-LG___
Children's Shirt: 6 8 10
RACE SELECTION:
Children's Run____ Adult 5K Walk____ Adult 5K Run
Please enter me or my child in the Phil Foley Memorial
5K Walk & Run Aug, 16, 2000. In consideration of your acceptance of
this application, I hereby, for myself, my child, our heirs,
executors, administrators, waive and release any and all rights and
claims for damages I may have against Albert Gallatin Planning and
Development Corporation, their representatives, successors, and
assigns for any and all injuries suffered by me or my child in this
event. Further, it is agreed that I release the rights to the
unconditional use of whatever photographs I might be a part of,
without remuneration or compensation.
Signature:_____________________________________________
Parent or Guardian (if under 18):______________________
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