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Saturday, June 3, 2000 -- Kanawha City
Run with a Cop 5K Run/Walk

Click here to return to the race Details Page

Applications should be mailed by May 27th, 2000!

Please make checks payable to: Law Enforcement for Special Olympics


NAME:_________________________________________________________


ADDRESS:______________________________________________________


CITY:__________________________________STATE:_____ZIP:________


PHONE#:________________________________SEX:______AGE:_________


T-SHIRT SIZE:  M____ L_____ XL_____

PLEASE CHECK WHICH EVENT YOU ARE ENTERING:

5K RUN_____($12.00)  5K WALK_____($10.00)  DAY OF RACE ADD $3
WAIVER: In consideration of the acceptance of this entry, I waive all rights and claims for damage that I may have against the City of Charleston, Special Olympics and all sponsors. I attest that I am physically fit and have trained for this event.

______________________________________________________________
SIGNATURE OF PARTICIPANT


______________________________________________________________
SIGNATURE OF PARENT OR LEGAL GUARDIAN (IF UNDER 18 YRS OF AGE)

SPONSOR SHEET Run With A Cop for Special Olympics
Name of Sponsor      Address        Donation      Paid