Saturday, September 17, 2011 -- Scottdale, PA
Scottdale Fall Festival 10K Run, 5K Run & Walk
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CONTACT: Charlie Ellis (phone) 724-887-7899
Fee $20 before September 16, $22 thereafter and day of race // Make check to Scottdale Fall Festival
Mail to Scottdale Fall Festival, 226 Pittsburgh Street, Scottdale, PA 15863
NAME:__________________________________________________________ ____MALE ADDRESS:_______________________________________________________ ____FEMALE _______________________________________________________ ____AGE (on race day) _______________________________________________________ PHONE: _______________________________________________________ Event: 10K___ 5K Run___ 5K Walk___ // Shirt Size: ___MED ___LG ___XLGIn consideration of your acceptance of my application for entrance in the Scottdale Fall Festival 10K Run / 5K Run / 5K Walk, I for myself and anyone entitled to act on my behalf, waive and release the Scottdale Fall Festival, all sponsors, their representatives, and successors from all claims or liabilities of any kind arising out of my participation in this event.
Signature of Entrant:___________________________________________________
(REQUIRED) parent or guardian signature required for those under 18