Entry Form

2nd Annual Band of Gold 5K Run/Walk - June 7, 2008

***Please Complete All Information***

Make checks payable to: South Point Band Boosters 

Mail to: South Point Band 5K, PO Box 321, South Point, Ohio 45680.   

Due by May 17, to guarantee you receive a t-shirt.

Amount Enclosed: $___________    Prior to race day, Adults - $15, Students (up to age 18) - $10

 

T-Shirt size (adult): ____S  ____M  ____L  ____XL  ____XXL  Youth: ____S  ____M  ____L  ____XL

 

Name: ________________________________________________

Address:_______________________________________________

City:_____________________________  State:_____________  Zip Code: __________

Phone:______________________  E-mail:____________________________________

Sex: M____  F____

Age on Race Day ________

WAIVER: In consideration of the right granted to me to participate in the Run for Gold 5K Run on June 7, 2008, I hereby waive all claims and damages against the South Point Band Boosters and any other sponsors and organizers arising from my participation or any injury I might suffer in this event.  I attest that I am physically fit and prepared for this event.  I understand that rollerblades, bikes, skateboards, etc. are not allowed.  Runners must sign below.

 

Runner's Signature _________________________________________  Date: _____________

 

Parent/Guardian (for minors under age 18) ___________________________________  Date: _________