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Sunday, April 10, 2005 -- Morgantown, WV
WVU College of Law 5K Ambulance Chase
(MAGP #3)
(iPO Event Id#: 6754)
Return to the Details Page
(Print neatly - Enter All Applicable Information & Sign)
NAME:_______________________________________________________________
STREET:__________________________________ CITY:_____________________
STATE:_______ ZIP:___________ PHONE:(______) ________-______________
EVENT --- 5K RUN:____ 5K FUN-WALK:____ MALE:____ FEMALE:____
DATE OF BIRTH (month/day/year) ____/____/____ AGE ON RACE DAY:______
SHIRT SIZE: Sm____ Med____ Large____ XLarge____ (Please Check One)
THE SMALL PRINT:
In consideration of your acceptance for entrance in the 4th
Annual WVU College of Law 5K "Ambulance Chase", I, for myself and anyone
entitled to act on my behalf, waive and release the WVU College of Law, all
sponsors, their representatives and successors from all claims and liabilities
of any kind arising out of my participation in this event.
___________________________________________________________________
SIGNATURE of ENTRANT
___________________________________________________________________
(Parent or Guardian, if under 18 years old)
Make checks payable to: WVU College of Law SBA
Mail to: WVU College of Law SBA, PO Box 6130, Morgantown, WV 26506
Fee enclosed: LAWYERS:
NON-LAWYERS:
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_____ $25
_____ $15 Run postmarked by Apr 4th
_____ $17 Run after Apr 4th, or race day
_____ $15 Fun Walk
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