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Saturday, June 2, 2001 -- Dawson, PA
Third Annual Tri-Town Three
(iPO Event Id#: 3495)
Sponsored by the Tri-Town Historical Society
Return me to the race Details Page
Please make checks payable to: The Tri Town Historical Society
Mail entry forms to:
The Tri Town Historical Society
PO BOX 1872
Dawson, PA, 15428-1872
Phone: (724) 529-2368
Sign me up for the ____5K Run ____5K Walk
Name:_________________________________________________
Address:______________________________________________
City:_______________________State:______Zip:__________
Phone_________________________________________________
Sex:______ Age:______ Date of Birth:____/____/_____
T-Shirt size: M____ L____ XL_____ XXL_____
WAIVER:
In consideration of my entry being accepted, I hereby, for myself, my
heirs, executors, successors, and assigns, waive, release, and
discharge any and all right for damages or liability of any kind
related to or arising out of my participation in this event, even
though that liability may arise out of negligence or carelessness on
the part of the entities or persons named in this waiver and
release. I attest that I am physically fit to participate, my
condition has been verified by a licensed medical doctor and I assume
entry into this race at my own risk. I have read the above conditions
and accept them and understand that I ame entering at my own risk.
Date___________ Signature____________________________
(Parent signature if under 18)
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