Saturday, July 3, 1999 -- Morgantown
1999 Spirit & Breath Challenge 5K/10K,
1 Mile Run & 5K Walk
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NAME:____________________________________________________
ADDRESS:_________________________________________________
CITY:____________________________STATE:______ZIP:________
PHONE #:_________________________________________________
AGE AS OF 7/3/99_____________ MALE________FEMALE________
In which event will you be participating?
10K RUN_____ 5K RUN_____ 1 MILE RUN_____ 5K WALK_____
GRAND PRIX PARTICIPANT? YES______ NO_______
T-SHIRT SIZE? SMALL____ MED____ LG____ XL____ XXL____
Race fee is $10.00 per person if postmarked by June 24, 1999,
and $13.00 if sent after this date or received on race day.
Reservations for the Pasta Festa must be recieved via phone or
by this entry form no later than June 24, 1999. Please make
checks payable to BOPARC, P.O. Box 590, Marilla Park, Morgantown,
WV 26507. To make reservations by phone for the buffet, call
(304) 296-8356.___YES, I will be attending the Pasta Festa, July 2, 1999.
___YES, I will be attending with_____guests. My guests will include____children six years of age or under. Enclosed, please find a check in the amount of $_________________.
___NO, I will be unable to attend the race or Pasta Festa, but would like to contribute to the research and treatment programs of the Comprehensive Lung Cancer Program at the Mary Babb Randolph Cancer Center. Please see that my check in the amount of $______________ made payable to the MBR Lung Cancer Education and Research Fund is forwarded to the Mary Babb Randolph Cancer Center.
RELEASE STATEMENT:
In consideration of acceptance of this entry, I waive any claims
for all damages which may result from my participation, or from
the participation of the minor that I am signing for in the 1999
Spirit & Breath Challenge. Any and all claims are waived for myself,
heirs and assigns. The sponsors and their agents or representatives
will assume no obligation for injuries or damages that may incur.
________________________________________________________________ SIGNATURE Date ________________________________________________________________ SIGNATURE OF PARENT OR GUARDIAN (If under 18) Date