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Saturday, June 2, 2001 -- Cairo, WV
Ridge Runner Races (iPO Event Id#: 2939)

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       Ridge Runner Races Application Form

Name:___________________________________________________

Address:________________________________________________

City:__________________________State:_____Zip:__________

Phone:______________________       Male:___ Female:____

Email:______________________  Birth Date:_______________

Race in which you would like to enter:   

        10 Mile       26.2 Mile Marathon

T-shirt size:(circle one)    S    M    L    XL

Entry Fees: $20.00 ($25.00 after 05/01/01) 
            for Marathon and 10 mile

Total Amount Enclosed: $___________
Race Waiver: I know that running a road race is a potentially hazardous activity. I should not enter and run unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I assume all risks associated with running in ths event including, but not limited to: falls, contact with other participants, the effects of weather, including high heat and/or humidity, traffic and the condition of the road, and such risks being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of your accepting my entry, I, for myself and anyone acting on my behalf, waive and release West Virginia State Parks and Recreation, North Bend State Park and all sponsers, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver.
________________________________________  ___________________
Signature:                                     Date:

________________________________________  ___________________
Parents Signature if under 18                  Date:

________________________________________  ___________________
Emergency Contact Name:                       Phone #: