Kennett Run
Saturday, May 17, 2008
Kennett Square, PA
To register: Complete this form and print it out
Make checks payable to: Kennett Square Run 2008
Mail to: Kennett Square Run 2007, P.O. Box 327, Kennett Square, PA 19348
Deadline for receiving pre-race registration forms and fees: May 9
|
Pre-registration until May 9 |
Day of Race
Entry |
| Check Event Entered: |
||
| 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:
T-Shirts to
the First 900 Registrants - except the Fun Walk
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: ______________________________________
