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Sunday, March 30, 2008 -- Morgantown, WV / Coopers Rock State Forest
Cooper's Rock 10K-MAGP Endurance #2 (iPO Event Id#: 10757)
Return to the Details Page (checks payable to W.Va. Track Club)
Please Print Legibly- Enter All Applicable Information & Sign
                                        

NAME_________________________________   MALE ___  FEMALE ___

ADDRESS______________________________   Birthdate____/____/____
                                                  mm / dd /yyyy   
       ______________________________   T-SHIRT M__ L__ XL__

PHONE  ______________________________   MAIL TO:
                                        W.Va. TRACK CLUB
EVENT    10K Run ____  5K Walk ____     P.O. BOX 4159
                                        MORGANTOWN, WV 26504
In consideration of your acceptance of my application for entrance in the Cooper's Rock 10K Run & 5K Walk, I, for myself and anyone entitled to act on my behalf, waive and release the Morgantown Roadrunners/West Virginia Track Club, and 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) ______________________________

Signature of Guardian (if under 18) ______________________________