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Thursday, July 4, 2013 -- Morgantown, WV / Start and Finish @ Morgantown Running
Morgantown Running 4 on the 4th (iPO Event Id#: 14749)

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RACE CONTACT: Morgantown Running (phone) 304-241-5223, (e-mail) info@morgantownrunning.com

  • $25.00 postmarked by 6/28/13/ or paid @ Morgantown Running on or before 7/2/13, $30.00 thereafter and the day of the race. Kids Run $15.00 (includes shirt).

  • Packet pick-up: 7/3@ Morgantown Running (4-6pm), 7/4 @ Morgantown Running 7am-8:15

  • Race day registration is from 7:00am-8:15am. You can register at Morgantown Running until July 3rd.

  • T-Shirts guaranteed for the first 125 registered. Availability of shirts for race day registrants is not guaranteed.

Payable to: Morgantown Running | Mail or drop-off this entry form with payment to:

Morgantown Running
709 Beechurst Ave. Suite 1A
Morgantown, WV 26505

** EACH RACER MUST FILL OUT AN ENTRY FORM **

Name:________________________________________________________________________________

Address: ____________________________________________________________________________

_____________________________________________________________________________________

Phone: (___________________________) ________________________________________________

E-mail:______________________________________________________________________________

Age on 07/04/13: _____ | Date of Birth:_____/_____/____________ | Male____ or Female___

Event category (check one) 4mile run _______ 2 Mile Walk__________

T-shirt size (check one): ___Small / ___Med / ___Large / ___XL

In consideration of your acceptance of my application for entrance in the 4on the 4th, I for myself and anyone entitled to act on my behalf, waive and release Heather 1, LLC/Morgantown Running, and all sponsors their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event.

______________________________________________________________________________________
Signature of Participant

______________________________________________________________________________________
Parent or Guardian Signature (if under 18 years of age)

_______________________________________________________
Date