Sunday, March 29, 2009 -- Morgantown, WV / Coopers Rock State Forest
Cooper's Rock 10K Run & 5K Walk
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Please make checks payable to: W.Va. Track Club
Mail to: W.Va. Track Club at PO Box 4159, Morgantown, WV 26504
Please Print Legibly- Enter All Applicable Information & Sign
NAME________________________________________________ MALE ___ FEMALE ___ ADDRESS_____________________________________________ Birthdate____/____/____ mm / dd /yyyy _____________________________________________ T-SHIRT M__ L__ XL__ PHONE _____________________________________________ EVENT 10K Run ____ 5K Walk ____Waiver - Must Sign: In consideration of your acceptance of my application for entrance in the Cooper's Rock 10K Run & 5K Walk, I, for myself and anyone entitled to act on my behalf, waive and release the Morgantown Roadrunners/West Virginia Track Club, and all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event.
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Signature of Entrant (Required)
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Signature of Guardian (if under 18)