September Stride 5K

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Saturday, September 9, 2000 -- Morgantown, WV
September Stride 5K

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Race fee is $13 for the general public if postmarked by Friday, September 1st. Employees of the Robert C. Byrd Health Sciences Center (WVUH, UHA, and Health Sciences at WVU) can enter for $10 if they register by Friday, September 1st. After this date and on race day, the cost is $15 for the general public and employees.

Make checks payable to: WVUH (no refunds will be given)

Mail to: September Stride
West Virginia University Hospitals
Rehabilitation Services
PO Box 8060
Morgantown, WV 26506-8060


Name:_____________________________________________

Address:__________________________________________

        __________________________________________

Phone:__________________________

Age on 9/9/00:______  DOB:___/___/___

MALE___   FEMALE___

Event: 5K Run___   5K Run/Heavyweight___  5K Walk___

T-shirt size:  M___  L___  XL___  XXL___

If you're an employee of the Robert C. Byrd Health Sciences Center, please check the correct entity; if you're a WVU Student, please check "student." WVU students can earn two hours of volunteer hour credits by participating in the race.

WVUH___  UHA___  Health Sciences___  Student___

Will you be attending the pasta dinner?  Yes___  No___

How many guests are you planning to bring to 
the pasta dinner?  ____
(Please note: if your guest(s) is/are not participating
in the event, the cost is $5 per person)

Total amount enclosed:_____

I hereby, for myself, my executors, and my administrators, waive any and all rights and claims I may have against West Virginia University Hospitals, individuals associated with this event, sponsors of this event, or suppliers for injury or damages suffered by me and which may arise out of or in any way be connected with this event. I knowingly assume all risks involved in this event.

Signature of participant_______________________________________________

parent or guardian signature___________________________________________
(if under 18)

Date____________________

Affiliates: WVMBA | MAGP | WVMTR | APRRS | WVCXS