Jingle Bell Run for Arthritis - Reston 8K
Sunday, December 2, 2001  9:00 AM

Make check payable to: Arthritis Foundation
Mail to: Jingle Bell Run - Reston, 13710 Ashby Road, Rockville, MD 20853-2903
Fax to: (301) 871-0006 before November 28         Don't Mail after November 26

Today's Date: , 2001           Event: 8K   3K Fun Run/Walk

Fee:$25  $30 if postmarked after Nov 24 and on raceday 
Kids under 12 - $10
Additional contribution to Arthritis Foundation   $ _____      I want to volunteer
I want to run on a team. My Team/Company name is: ___________________

Last Name:
Address:
City: State: Zip: -
Age on race day: Sex: M F    E-Mail:
Date of Birth: / / Shirt Size:   S M L XL      
Day Phone: - - Night Phone: - -

Credit Card: MC Visa Amex - - - 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 inconsideration of your accepting my entry, I, for myself, and anyone else acting on my benefit waive and release and indemnify the Jingle Bell Run for Arthritis, Arthritis Foundation, Reston Runners, 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 by Reston Runners.

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