2nd Annual Drew's Day Race Application
2nd Annual Drew’s Day 5k! 5K RUN/WALK APRIL 12, 2008 ST. ALBANS 9:00AM
$15.00 DOLLAR ENTRY FEE – PROCEEDS BENEFIT MOUNTAINEER SPINA BIFIDA CAMP NAME:____________________________________________________ ADDRESS:___________________________________________________________________________________________________________________________________________________________________ PHONE:___________________________________________ MALE:_____FEMALE:______AGE:______________ EVENT: (circle) RUN WALK SHIRT SIZE: (adult) S M L XL Other:_____ (FIRST 100 RECEIVE T-SHIRTS; AWARDS FOR FIRST FINISHERS IN DIVISIONS) WAIVER: In consideration of the acceptance of this entry, I 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. I also release any photos that may involve myself.
___________________________________________________________________ SIGNATURE (PARENT OR GUARDIAN, IF UNDER 18)
REGISTRATION WILL BEGIN AT 8:15. THE RUN/WALK BEGINS AT 9:00AM. –MEET AT THE LOOP IN ST. ALBANS
Make checks payable to : Mountaineer Spina Bifida Camp Mail to: Susan Nelsen c/o Bridgeview Elementary, 5100 Ohio st. So. Charleston 25309
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