Registration Form for the 3M 5K: Racing to Save Lives
Saturday, October 20, 2001 - 9:00 AM

Make check payable to: The Marrow Foundation           
Mail to: 3M 5K, 13710 Ashby Road, Rockville, Maryland 20953-2903
Fax credit card entries to: (301) 871-0006 before October 16     Don't mail after October 13

Today's Date:   , 2001        Did you run last year?    Yes No  
5K     Fun Walk             I would like to volunteer                         
5K & Fun Walk Entry Fees: $15    $18 after October 8      $20 on raceday 
Are you on a team (4 to 6 runners per team)?   Coed  Female  Male
What is the name of your team? ___________________________________
Would you like to make an additional contribution to the Marrow Foundation?  $ _______________   
I am a ChampionChip Owner and am deducting $2. My Chip number is
I want to buy my own ChampionChip.  I am enclosing $35 payable to Capital Running Co.
    Last Name:      
Address:  
City:       State:        Zip:   -
Age on race day:           Sex: M  F                                                                                              
Date of Birth:   / /     Shirt Size:  S M  L  XL
Home Phone:   - -     E-Mail:  
Credit Card: MC  Visa   ---  Exp:  

Cardholder's Signature (Mandatory) __________________________________________

Waiver/Release Must be Signed Before Mailing:

I know that running is a potentially hazardous activity and I should not enter unless I am medically able and properly trained. I assume all risks associated with running in this event including, but not limited to, falls, contact with other participants, the effects of weather and the conditions of the road, all such risks being known and appreciated by me. Having read this waiver and knowing the facts and in consideration of your accepting my entry, I, for myself, and anyone else acting on my benefit waive and release and indemnify the 3M, The Marrow Foundation, Capital Running Company, USATF plus all sponsors, their representatives and assignors from all claims or liabilities of any kind arising out of my participation in this event, even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. Race management and finish line services by Capital Running Company.

_________________________________________________________     __________
Signature (parent or guardian if under 18)                                                              Date