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Sunday, October 2, 2005 -- Elkins, WV
Forest Festival 10K - (Century Series #7) (iPO Event Id#: 6901)

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Mail Entry to: Jeanine Zurbuch, 118 Scott Ford Road, Elkins, WV 26241



Name:________________________________________________

Address:______________________________________________

City/State______________________________Zip_____________

Age as of 10/2/05______ Male/Female:______________________
Walk______    Run______
Shirt Size (Circle): Adult S-M-L-XL-XXL       Youth S-M-L
Waiver and Release: I agree to assume all risks of injury, damages, or liability associated with participation in the 2005 Forest Festival 10KM Run/ 5KM Walk. I understand that there are certain risks inherent in participating in athletic sporting events including, but not limited to, personal injury and property damage. I further agree to hold the Mountain State Forest Festival, their agents, employees, and volunteers harmless from and waive all liability, actions, cause of actions, claims, expenses, and damages on account of injury caused by their negligence or otherwise. I further state that I have carefully read the foregoing release and know the contents thereof and sign this release of my own free act.

______________________________________________________________
Signature (Parents Signature if participant under 18)   Date