Saturday, April 30, 2011 -- Morgantown, WV / Jack Roberts Park, First Ward
Parents Place 5K Run/Walk
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RACE CONTACT: Adrian Kettering (phone) 304-685-7192
Entry Fee: If you register before April 18, 2011, the registration cost is $18.00. All entrants who register after April 18 will be charged $20.00. Fees are nonrefundable. Please make checks payable to: Parents' Place.
Make checks payable to: Parents' Place
Mail to: Parents' Place, 105 Summit Overlook Drive, Morgantown, WV 26508
Name:____________________________________________ Phone:_______________________
Address:__________________________________________ Date of Birth:_____________
Age as of 4/30/11:________ / Male:___ or Female:___
T-shirt size: Small:___ / Medium:___ / Large:___ / X-Large:____
Please check your choice for the event: Running_________ or Walking__________
In consideration of your acceptance of my application for entrance in the Parents' Place 5K, I, for myself and anyone entitled to act on my behalf, waive and release Parents' Place and all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event. I release any photos that may involve myself:
Signature: ___________________________________________________________________
Date: __________________
Entrant's Signature Parent of Guardian, if under 18:
Signature: ___________________________________________________________________
Date: __________________