Kennett Run
Saturday, May 15, 2010
Kennett Square, PA
To register: Complete this form and print it out
Make checks payable to: Kennett Run 2010
Mail to: Kennett Run 2010, P.O. Box 327, Kennett Square, PA 19348
Deadline for receiving pre-race registration forms and fees: May 10ATTENTION!! Registration for the 10K, 5K, and 5K Walk is limited to 3000 runners combined.
Pre-registration guarantees your spot!!
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Pre-registration until May 10 |
Day of Race
Entry |
| Check Event Entered: |
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| 10K Run | 10K PoweRun© | 5K Race Walk |
| 5K Run | 5K PoweRun© | 1 Mile Fun Walk |
| 1Mile Kids Run (13 & under) |
Team Name:*
*Send all team registrations together
Club Affiliation:
Last Name:
First Name:
Free T-shirts - except the Fun Walk
and 1-Mile Kids Run participants
Male Female Age on Race Day: Phone:
Mailing Address:
City: State: Zip Code:
Email Address:
In consideration of your permitting me to participate in this event, on behalf of myself, my heirs, executors, administrators, successors and assigns, I hereby waive and release all rights and claims for damages which I may have against you or your assigns, the municipalities in which the event occurs, or anyone connected with the event, their heirs, executors, administrators, successors, and assigns, for any and all injuries or illnesses which I may suffer as a result of taking part in the event. I grant my permission to use my name or any audio or visual recording for any lawful purpose.
Signature: __________________________________________ Date: ________________
Parent's Signature if Under 18 years of Age: ______________________________________