Saturday, April 25, 2009 -- Morgantown, WV / Jack Roberts Park, First Ward neighborhood
Parents Place 5K Run & Walk ENTRY FORM
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Early Registration is $15.00 MUST BE POSTMARKED BY APRIL 14th! // Race Day Registration is $18.00
Make checks payable to: Parents' Place
Mail to: Parents' Place, 312 Jackson Avenue, Morgantown, WV 26501
Name:____________________________________________ Phone:_______________________
Address:__________________________________________ Date of Birth:_____________
Age as of 4/25/09:________ / Male:___ or Female:___
T-shirt size: Small:___ / Medium:___ / Large:___ / X-Large:____
Please check your choice for the event: Running_________ or Walking__________
In consideration of your acceptance of my application for entrance in the Parents' Place 5K, I, for myself and anyone entitled to act on my behalf, waive and release Parents' Place and all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event. I release any photos that may involve myself:
Signature: ________________________________________ Date__________________
Entrant's Signature Parent of Guardian, if under 18:
Signature: ________________________________________ Date__________________