Saturday, July 23, 2011 -- Morgantown, WV
Generation Morgantown Canine Classic 5K ENTRY FORM
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- FEE . . . BEFORE July 15th: $15.00 per adult, $10.00 per child (under 16), Dogs run FREE
- FEE . . . AFTER July 15th through race day: $20.00 per adult, $15.00 per child (under 16), Dogs run FREE
T-Shirts will be guaranteed for the first 100 registrants. Make Checks payable to: GMCT-Generation Morgantown Fund
Send payment to: Canine Classic 5K, c/o GMCT, P.O. Box 409, Morgantown, WV 26507
Name:___________________________________________________________________________
Gender: male____ female____ // Age: ______ (as of 07/23/11) Date:_______________
Phone: (_______________)______________________________________
E-mail:_______________________________________________________
Adult T-Shirt Size (check one): S____ / M____ / L____ / XL____
Address:________________________________________________________________________
. . . . . . . . . . (street/city)
________________________________________________________________________________
. . . . . . . . . . (state/zip)
(check one) Runner:__________ Walker:________
Amount Enclosed: $_____________________________
In case of emergency, Please notify:
Name:___________________________________________________________________________
Relationship: __________________________________________________________________
Phone: (_______________)______________________________________
WAIVER . . . In consideration of acceptance of this entry, I waive any and all claims for injuries or damages which may result from my participation, or from the participation of the minor or pet that I am signing for in the Generation Morgantown Canine Classic. Any and all claims are waived for myself, heirs and assigns. Generation Morgantown, the sponsors and their agents or representatives will assume no obligation for injuries or damages that may be incurred.
Pet's Name:_____________________________________________________________________________
Owner's Signature:______________________________________________________________________
Signature of Parent or Guardian:________________________________________________________
(Parent's or Guardian's signature required if contestant is under 18 years of age)