Saturday, October 11, 2008 -- Uniontown, PA
3rd Annual FCDAC, Inc. Red Ribbon 5K (iPO Event Id#: 11185)

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Please make checks or money orders payable to FCDAC, Inc.

Mail to: 100 New Salem Rd., Suite 106, Uniontown, PA 15401 // Please Note in MEMO section: 5K Run/Walk

Full Name__________________________________________________________________

Address ___________________________________________________________________

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Phone number (____________) ___________________________________

Date of Birth __________________ Age as of 10/11/08____________ Sex ________

Circle one: Runner or Walker // Circle one: T-shirt size: S.. M.. L.. XL.. XXL.. (Additional $3.00) T-shirts are not guaranteed after September 29, 2008. If you are pre-registered for the event and not in attendance, your t-shirt will be held for one-week following the race. T-shirts will not be mailed.

WAIVER: In consideration of my entry being accepted in the Red Ribbon 5K Run/Walk, I waive myself, my heirs, executors, and assigns, any all claims for damages or injuries I may receive during this contest. I am in good physical health and agree to all rules and regulations of this event. Permission is granted to release any photos that include my image. NO PETS are allowed on campus.

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Signature

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Date

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Parent/Legal Guardian signature if entrant is under age 18