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Saturday, June 2, 2012 -- Charleston, WV
WVSO Beat Beethoven 5K Fun Run/Walk ENTRY FORM (iPO Event Id#: 14086)

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RACE CONTACT: Katie Monroe (phone) 304-340-1266 (email)

$20.00 pre-registration by May 18, 2012 . . . $25.00 after May 18, 2012

Only pre-registered participants are guaranteed a T-shirt, Race Day Registration starts at 8:15 am . . . Race starts at 9:00 am

Checks payable to: WVSO
Mail completed entry form to: Symphony Fun Run/Walk * P.O. Box 11887 * Charleston, WV 25339


MAILING ADDRESS____________________________________________________




AGE BRACKET: _____20 & Under /_____21-30 /_____31-40 /_____41-50 
             _____51-60 /_____61+  

GENDER: ____Male or ____Female  I Plan to: _____WALK _____RUN

T-Shirt Size (Performance T): __________ 

Only pre-registered participants are guaranteed a t-shirt

Discalimer: "In consideration of your accepting this entry, I, the undersigned, intending to be legally bound, hereby, for myself, my heirs, executors, and administrators, waive and release any and all rights and claims for damages I may have against the West Virginia Symphony Orchestra, sponsors, the City of Charleston, the County of Kanawha, the State of West Virginia, and volunteers of the race, their representatives, successors and assignors, of any and all injuries suffered by me in said event. I attest and verify that I am physically fit and have trained for the competition of this race and my physical condition has been verified by a licensed medical doctor."

Signature (Parent/Guardian must sign if under 18)