Saturday, April 16, 2011 -- Danese, WV / Babcock State Park
The Gristmill Grinder Half Marathon Trail Run ENTRY FORM
CONTACT: Donnie Hudspeth - Mountain Air Productions (phone) 304-658-5016 / 800-950-2585, (e-mail) info@gauleyrace.com
Registration for the Half Marathon . . . Race Day 8:00-9:30 am, Race at 10:00 am
- Pre-registration / RUN: $25 if postmarked by March 30, 2011 .. $30 thereafter
- Registration / WALK: $15 if postmarked by March 30, 2011 .. $20 thereafter
** Shirts are guaranteed to all pre-registered entries!
Please make checks payable to: Mountain Air Productions
Mail entry forms to:
Donnie Hudspeth Mountain Air Productions
P O Box 102, Hico, WV 25854
NAME:_______________________________________________________________________
ADDRESS:____________________________________________________________________
CITY:_______________________________ STATE:__________ ZIP CODE______________
PHONE:(________)_________________ E-MAIL:____________________________________
Female______ Male______ Age_______ // Shirt Size: S_____M______ L_____ XL_____
* (T-shirt guaranteed to all who pre-register)
WAIVER: For and in consideration of my participation in the Babcock Gristmill Grinder Half-Marathon Trail Run, I, the undersigned, release forever the sponsors, the program, its members, volunteers, co-sponsors, landowners, race organizers, race directors, other participants and all those associated with the Babcock Gristmill Grinder Half-Marathon Trail Run from any claim for harm, injury or loss that occurs to me or my child/ward or anyone on his/her behalf as a result of participation in this event. I therefore attest and verify that I am physically fit and have sufficiently trained for this event and am aware of the potential dangers.
SIGNATURE:__________________________________________________________________________
....................... (PARENT/GUARDIAN IF UNDER 18)