Please fll out this registration form and send it and your registration fee to:

Alicia Stradley, 158 Montrose Ave, Bufalo ! 1"#1"

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%ity$$$$$$$$$$$$$$$$$$$$$$$$$$$$$ State$$$$$ &i'$$$$$$$$$$$$$$
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Age on +ace ,ay$$$$$$$$$$$$ -ender (circle one) Male
.emale
Registering for (circle one) Tshirt size
5/ 0ids1 .un +un !S !M !2 !32 S M 2 32 332
4 understand that running a trail race is a 'otentially ha5ardous activity6 4 should not enter and
run unless 4 am medically a7le 8 'ro'erly trained6 4 agree to a7ide 7y the decision of the race
o9cials relative to my a7ility to safely com'lete the event6 4 assume all ris/s associated :ith
running;:al/ing this event including, 7ut not limited to, falls, contact :ith other runners, the
efects of the :eather, 8 the conditions of the course, all such ris/s 7eing /no:n 8 a''reciated
7y me6 4 grant 'ermission to the organi5ing grou's to use any 'hotogra'h, motion 'ictures or
recordings of my ta/ing 'art in this event for any legitimate 'ur'ose6
<aving read this :aiver ac/no:ledging these facts 8 in consideration of you acce'ting my entry,
4 for myself, 8 everyone entitled to act on my 7ehalf, :aive and release %am' %herith of =!,
volunteers 8 any and all race s'onsors from any claims or lia7ilities of any /ind arising out of my
'artici'ation in this event6 4 understand that all entry fees are nonrefunda7le6
4 have read this :aiver 8 certify my com'liance 8 agreement :ith its content :ith my signature6
+unner Signature: Parent; -uardian Signature (if under 18)
Registration for %am' %herith 5K and
Fun Run
Saturday, August >?
th
, #?1"
+ace 7egins at 11:??am
2ocated at %am' %herith =!
@5>" Short Aract +d
<unt ! 1"8"B
PreCregistration fee: D#? (By Aug #>) %hec/s made
'aya7le to:
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