Saturday, August 4, 2012 -- Clarksburg, WV / Clarksburg City Park, Nutter Fort
WV Blackberry Festival 5-K
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RACE CONTACT: J.B. Forinash (e-mail) blackberry5k@yahoo.com
$13.00 ... Post-marked by July 25
$15.00 ... Post-marked after July 25 and on race day
No mailed-in entries accepted after July 25. To be assured of a free t-shirt, you must be one of the first 150 entrants. Exact sizes, however, cannot be guaranteed.
Make check payable to and mail checks and application to:
West Virginia Blackberry Festival 5-K
c/o J.B. Forinash
P.O. Box 8088
Nutter Fort, WV 26301
PLEASE PRINT CLEARLY
Name: _______________________________________________________________________________
Address:_____________________________________________________________________________
Phone: (__________________) __________________________________________
E-mail _______________________________________________________________
______________________________________________________________________
HOW DID YOU HEAR ABOUT THE RACE (Friend, On-Line, etc.)
Age on 8/6/11: __________ // Gender: Male_____ Female_____ // Shirt Size: S____ M____ L____ XL____
Waiver: In consideration of acceptance of this entry to the West Virginia Blackberry Festival 5K Run, I waive all claims for myself, my heirs and assigns against the race sponsors, promoters, or officials due to injury or illness which may result from my participation. I attest and verify that I have full knowledge of the risk involved in these events. I am physically fit, and sufficiently trained to participate. I have read the above statement, I understand it, and my signature confirms its full acceptance.
Signature____________________________________________________________________________
Date_______________________________
_____________________________________________________________________________________
Parent/Guardian if under 18 years
Date_______________________________