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Sunday, March 23, 2014 -- Grafton, WV / Grafton High School
Grafton Five Mile Run (iPO Event Id#: 15028)

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RACE CONTACT: Eva Robinson (e-mail) erobinso@access.k12.wv.us, (phone) 304-265-3046 /daytime only

FEE 5 Mile Run & 2 Mile Walk: $15 (by 3/17/14), $15 (on race day WITHOUT T-shirt)

FEE Kids Run: $3.00 (WITHOUT shirt)

Payable to: Grafton High School . . . Mail to: Grafton High School, 400 Riverside Drive Grafton, WV 26354



NAME:_____________________________________________________________________________

STREET:___________________________________________________________________________

CITY:____________________________________________STATE:________ZIP:_______________           

PHONE:(__________) _______________-______________________

EMAIL:___________________________________________________

EVENT: 5 Mile Run:___ 2 Mile Walk:___  Kids Run:___ //   MALE:____  or FEMALE:____   

AGE:___ (On March 23, 2014)  // SHIRTS SIZE (adult): S   M   L   XL

WAIVER: In consideration of the acceptance of this entry, l waive for myself, my heirs, and assigns, all claims for damages which I might have against the race, its sponsors, or any other organization, business, or individual as a result of any and all injuries which might be received during the contest. l also release any photos that may involve myself.


__________________________________________________________________________________
SIGNATURE --- (Parent or Guardian, if participant under 18 years old)