Phone #_____________________________ Age on 12/2/00___________Sex_________
$15 Long Sleeve T-Shirt Size S__M__L__XL__XXL__and Children (10-12)___(14-16)___
Entry fee: $15.00 in Advance $20.00 Late Registration Fee postmarked after Tuesday, November 28th and the day of the race.
Release: In consideration of this entry, I waive any and all claims for myself, my heirs, executors and administrator against officials, host sponsors and directors of any illness or injury which may result directly or indirectly from participation. I further state that I am in proper physical condition to participate in this event.