|
|
| Waiver:
In consideration of your accepting my entry, I intending to be legally
bound, do hereby for myself, my heirs, executor, and administrators,
waive and release any and all rights to claims or damages I may incur
against Foundation West, the Fresno County Office of Education, the city of Fresno, members of this committee, and all sponsors, race director,
race officials, their agents, representatives, successors or assigns
for any and all injuries, ailments or other consequences suffered
by me resulting from my participation in the 14th Annual Dream Run.
I have carefully read and understand this waivers contents. |
| |
Signature
of Participant (Parent or Guardian, if participant is under 18 years old)
x __________________________________________________________ |
|
PLEASE
PRINT (ONE ENTRY PER PARTICIPANT)
|
| Name__________________________________________________________ |
| Address________________________________________________________ |
| City___________State____Zip_______E-Mail
Address:_________________ |
| Phone________________Race
Day Age_________ |
| Male____Female_____ |
|
|
|
| |
Official
Use Only
Race#___________________
|
|
|
2
MILE RUN
|
6
MILE RUN
|
2
MILE WALK
|
KIDS
RUN
|
|
(mark
age group)
|
(mark
age group)
|
(mark
age group)
|
(mark
age group)
|
| [
] 7-11 |
[
] 7-11 |
[
] 0-39 |
[
] 1/8 Mile Run (ages 2,3,4) |
| [
] 12-15 |
[
] 12-15 |
[
] 40-59 |
[
] 1/4 Mile Run (ages 5,6) |
| [
] 16-19 |
[
] 16-19 |
[
] 60+ |
[
] 1/2 Mile Run (ages 7,8,9) |
| [
] 20-24 |
[
] 20-24 |
|
|
| [
] 25-29 |
[
] 25-29 |
|
OUR SIGNATURE LONG-SLEEVE T-SHIRT
T-SHIRT
SIZE
(mark size)
|
| [
] Kid's Race
|
| |
|
[
] 2 Mile / 6Mile (Adult Sizes)
| [
] Small |
[
] Med |
[
] Large |
[
] XL |
|
|
|
| [
] 30-34 |
[
] 30-34 |
| [
] 35-39 |
[
] 35-39 |
| [
] 40-44 |
[
] 40-44 |
| [
] 45-49 |
[
] 45-49 |
| [
] 50-54 |
[
] 50-54 |
| [
] 55-59 |
[
] 55-59 |
| [
] 60-64 |
[
] 60-64 |
|
|
| [
] 65-69 |
[
] 65-69 |
Make
check payable to:
DREAM RUN
P.O. Box 28424, Fresno, CA 93729
|
| [
] 70-74 |
[
] 70-74 |
| [
] 75+ |
[
] 75+ |
| [
] wheelchair |
[
] wheelchair |
|
|
| |
|
|
|
|
|
For
more information call:
(559) 227-0152, or (559) 275-6318
|
|
