Saturday, October 26, 2013 -- Morgantown, WV / United States
3rd Halloween Hustle 5K Run/Walk
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RACE CONTACT: Angela Carver (phone) 304-287-6271 (email) CDMofWV@gmail.com
- $15 if postmarked by October 05, 2013.
- $20 therafter and on race day.
- Day of race registration and race check-in at the CDMWV.
- T-shirts for all pre-registered 5K participants.
Mail form and fee to: CDM Halloween Hustle 5K Registration Form , P.O. Box 104, Morgantown, WV 26507-0104
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NAME
GENDER: ____male or ____female // Age on Race Day: _____/_____/_________
________________________________________________________________________
ADDRESS
CITY______________________________________/ STATE______/ ZIP_____________
PHONE (______________________) ___________________________________
E-MAIL____________________________________________________________
5k Run_____ 5K Walk____ Indoor 1 Mile Fun Walk____
T-Shirt Size (check one): ___SMALL / ___MED / ___LG / ___XL (all adult sizes)
I agree to defend, indemnify and hold GP Mountaineer, LLC and/or Childrens Discovery Museum of WV their officers, agents, trustees and directors, harmless from all injury, loss, cost, claims or damage to any person or property arising from, related to, or in any way connected to use of the Moun-taineer Mall or any conduct undertaken by me thereat. I further waive my rights to assert any claim for loss, cost, injury or damages against GP Moun-taineer LLC and/or Childrens Discovery Museum of WV their officers, present or arising at any time in the future, arising from, related to, or in any way connected with the use of the Mountaineer Mall or conduct undertaken by me thereat. Any individuals meeting state criteria for business registra-tion are solely responsible for obtaining and maintaining all licenses and permits.
________________________________________________________________
SIGNATURE (indicates agreement of waiver)
________________________________________
DATE
________________________________________________________________
SIGNATURE of Parent or Legal Guardian if under 18
________________________________________
DATE