2006 Champion Chris Chattin
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Men in Kilts 5K
Sunday, November 9, 2008 8:30 AM Start
Maryland State Fairgrounds
Timonium, MD
Entry Fees:
$10 prior to Irish Festival(Nov 7th)
-- $15 thereafter
no confirmations or refunds
First Name: Last
Name:
Address:
City: State:
Zip:
-
Age on race day:
Sex: M
F
Date of Birth:
/
/
Waist Size (for kilts) (Men’s Sizing 30-44)
Day Phone:
-
-
Evening
Phone: -
-
Email:
I am enclosing my entry fee in the
amount of: $
I am enclosing an extra $15 to
buy a kilt $
Total enclosed (absolutely no refunds):
$
In consideration of my
application being accepted, I hereby for myself, my heirs, personal
representatives and executors, waive, release and forever discharge any and all
claims for loss or damages which I may have or may hereafter accrue to me
against the organizers and sponsors of the Men in Kilts 5K Run/Walk, including
without limitation any sponsors, patrons or supporters and their respective
representatives, successors, and assigns, for any and all injuries which might
be suffered by me in said event. I attest and verify that I am physically fit
and have sufficiently trained for the completion of this race. Further, I hereby
grant full permission to any and all of the foregoing to use my name,
photographs, videotapes, motion pictures, recordings or any other record of this
event for any legitimate purpose, without compensation or remuneration.
__________________________________________________________________________
Signature (parent or guardian if under
18) Date