2004 Labor Day 5K
Monday, September 6, 2004, 10:00 AM
______________________________
Registration
Form (Please Print)
Name:____________________________
Age:_______
Gender:
M or
F
Address:___________________ City:__________ State:_____ Zip:______ Phone:_________
EMAIL: ____________________________________________________________________
SHIRT
SIZE (If applicable): S
M L XL
COSTS:
$7.00 without Shirt (if post marked by Aug 25), $10.00 After
$12.00 with Shirt (if post marked by Aug 25), $15.00 After
Please
read the following statement and sign below before submitting entry.
In consideration of the acceptance of my entry, I do hereby acknowledge
that I assume all risks resulting therefrom, and I do hereby, for myself, my
heirs, my executors and/or administrators, waive, release, and forever discharge
any and all sponsors and organizers, their officers, agents and assigns, the
race director and volunteers from any and all liability arising from illness,
injuries, or damages I may suffer as a result of my participation in the LABOR
DAY 5K . I understand that traffic control on
the course will be limited and that I must watch for vehicles at intersections
and on the roadway.
Signature:
_________________________________ Date:__________
Parent/Guardian
(if under 18 years of age): __________________________Date: __________
Mail Entry Form and Fees to:
LCSC Cross Country
LCSC Athletics
500 8th Avenue
Lewiston,
ID 83501