Somerset's Back-to-School Classic 8K and 2K Run/Health Walk
Sunday, September 30, 2001 - 8:00 AM

Make check payable to: Somerset Elementary School PTA
Mail to: Somerset PTA, PO Box 151707, Chevy Chase, MD 20825
Fax to: (301) 871-0006 before September 26        Don't mail after September 24

Today's Date: , 2001          Event: 8K   2K Fun Run/Walk
Entry Fee: $15   $20 if postmarked after August 31 $25 raceday
Kids 18 and under $15, no deadline
Extra T-shirts (Includes brunch): $15    Fun Run Free (T-shirts $15)
Additional Contribution to Somerset PTA $ _________________

Last Name:
Address:
City: State: Zip: -
Age on race day: Sex: M F E-Mail:
Date of Birth: / / Shirt Size: S M L XL Child: M L
Day Phone: - - Night Phone: - -
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 organizers of the Back to School Classic, Somerset Elementary School and its PTA, The Town of Somerset, Evers and Company Real Estate, Capital Running Company, 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. Finish line services provided by Capital Running Company.

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

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