Saturday, July 11, 2009 -- Arthurdale, WV / Arthurdale Heritage Museum grounds
Beth Bonner Memorial 5K Run & 2-M Walk ENTRY FORM
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Entry Fee: $15 pre-registered before July 4; $20 after July 3 and day of race.
Make non-refundable checks payable to: Arthurdale Heritage, Inc.
Mail To: NEW DEAL FESTIVAL 5K RUN & 2-MILE WALK, PO Box 850, Arthurdale WV 26520
Waiver (MUST SIGN): In consideration of acceptance of this entry, I for myself, my executors, administrators and assignees do hereby release Arthurdale Heritage, Inc. and other race sponsors for all claims of damage, demands, actions whatever in any manner arising or growing out of my participation in said athletic event. I attest and verify that I have full knowledge of the risks involved in this event and I am physically fit and sufficiently trained to participate in this event. I also release any photos that may involve myself.
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Signature of Participant or Guardian (if participant is under the age of 18)
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Date
Name___________________________________________________________________
Age on 7/11/09_________ --- Birth Date ____/____/____
Address________________________________________________________________
State_______________________Zip_______________________
Phone ( )______________________________________Sex: M ___ F ____
Email __________________________________ Event: Run_____ Walk_____
T-Shirt size: S_____ M_____ L_____ XL_____