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Sunday, August 3, 2008 -- Morgantown, WV / Gene's Place, South Park
Gene's Run For Special Olympics - MAGP Endurance #7 (iPO Event Id#: 10821)

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Please make checks payable to: Monongalia County Special Olympics
$17.00 if piad by July 26. The late registration fee is $20.00
Mail to: Gene's Run for Special Olympics, P.O. Box 41, Morgantown, WV 26505

Run ____    Grand Prix Entrant ____        Walk ____


NAME___________________________________________________


ADDRESS________________________________________________


CITY____________________________STATE______ZIP_________


PHONE__________________________________________________


(Please Circle One) T-SHIRT SIZE:    L     XL    XXL


Male___ Female___      Birth Date______/______/_______


*Age as of August 3, 2008 _______________
In return for permission by the Monongalia County Special Olympics to participate in Gene's 4 mile run or walk, I release the program, its members, volunteers, co-sponsors, and other participants from any claim for injury or loss that occurs to me or my child/ward or anyone on his or her behalf. I therefore attest and verify that I am physically fit and have sufficiently trained for this event.

__________________________________________________________
SIGNATURE (PARENT OR GUARDIAN MUST SIGN IF UNDER 18)