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 10

ATTENTION!!  Registration for the 10K, 5K, and 5K Walk is limited to 3000 runners combined. 

Pre-registration guarantees your spot!!

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: ______________________________________