Saturday, October 13, 2007 -- Uniontown, PA / Penn State University, Fayette Campus
2nd Annual FCDAC, Inc. Red Ribbon 5K Run/ Walk
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Please make checks or money orders payable to FCDAC, Inc.
Mail to: 100 New Salem Rd., Suite 106, Uniontown, PA 15401 // Please Note in MEMO section: 5K Run/Walk
Full Name__________________________________________________________________
Address ___________________________________________________________________
___________________________________________________________________________
Phone number (____________) ___________________________________
Date of Birth __________________ Age as of 10/13/07____________ Sex ________
Circle one: Runner or Walker // Circle one: T-shirt size: S.. M.. L.. XL.. XXL.. (Additional $3.00)
T-shirts are not guaranteed after October 1, 2007. If you are pre-registered for the event and not in attendance, your t-shirt will be held for one-week following the race. T-shirts will not be mailed.
WAIVER: In consideration of my entry being accepted in the Red Ribbon 5K Run/Walk, I waive myself, my heirs, executors, and assigns, any all claims for damages or injuries I may receive during this contest. I am in good physical health and agree all rules and regulations of this event. Permission is granted to release any photos that include my image.
Signature____________________________________________Date________________
Parent or legal guardian signature if entrant is under 18
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