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Saturday, May 7, 2011 -- Kingwood, WV
Cheat River Festival 5K ENTRY FORM (iPO Event Id#: 13302)

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RACE CONTACT: Andrew Miller (phone) 304-329-3621 (e-mail)

Fee: Early registration $20.00 must be postmarked by April 30h 2011, thereafter $25.00.

Registration includes admission to the Cheat River Festival for all runners and a free Cheat Fest 5K T-shirt for the first 100 registered runners.

Make checks/mail entry form to:

Friends of the Cheat, Inc., 119 S. Price Street, Suite 206, Kingwood, WV 26537

Name: _______________________________________________________

Address: ____________________________________________________

Town: _______________________________________________________

State: ________________________ Zipcode: ____________________

Phone: (______________)______________________________________

E-mail: _____________________________________________________

Date of Birth: ____________________ Age as of 5/7/2011: ____________

Male: _______________________ Female: _____________________________

Where did you hear about the 5K?


Please Check Tee-Shirt Size: Small____ Medium_____ Large_____ XLarge_____

In consideration of your acceptance of my application for entrance in the Cheat Fest 5K, I for myself and anyone entitled to act on my behalf, waive and release FOC and all sponsors, their representatives and successors from all claims or liabilities of any kind arising out my participation in this event. You MUST Sign.

Date: _____________________________

Signature: ______________________________________________________________

Entrant's Signature: ____________________________________________________

Parent/Guardian, if under 18:____________________________________________