Join us for the fourth race in the Kids Championship Series. No fee, but registration is required. Register via mail using the form below. Pre-registration preferred! Kids races will
start at 9:15 am. Kids races will range from 100 yds to 1-mile.
Please contact Susan Noble with questions at susanmnoble@verizon.net.
OFFICIAL ENTRY FORM
Kids Run in
conjunction with
Held at Severna Park High School
June 15, 2008 – Kids Run starts at 9:15
am.
To register, complete and return this form (no fee required).
Mail to: Susan Noble,
Sex: M F
DATE OF BIRTH: ________________
Age on June 15 2008:__________
Mom or Dad Strider: Yes
No
Waiver and Release: I recognize that
participation in this activity may involve
certain hazards. I understand that I should
not participate unless medically able. I
assume the risks associated with
involvement in this activity, including but not limited
to falls, contact with participants,
effects of weather and road and traffic conditions,
these risks being known and appreciated by
me. Having read this Waiver Release
and considering the acceptance of my
application, I, for myself and anyone entitled
to act on my behalf, waive and release the
Club of America, all sponsors and hosts,
and their representatives and successors,
from any claim of liability arising
from my involvement in this activity.
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NAME:
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ADDRESS:
CITY/STATE/ZIP:
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PHONE: EMAIL:
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SIGNATURE OF ENTRANT
OR PARENT IF UNDER 18:
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