4th. Annual

Groom Creek Community Classic

10K Run ~ 5K Run ~ 2 Mile Fun Run/Walk

September 27, 2008

Registration Starts @  7:15 a.m.

Races Start @  8:00 a.m. 10K ~ 8:15 a.m.  5K ~ 8:30 a.m. 2 Mile Fun Run

This event will benefit the 100 Club of Arizona

Location:

Registration Form

Please fill-out, print and sign the form.

Make check Payable to:  Groom Creek Fire District

                               Mail to: Groom Creek Fire District

                                              Attn: Race Coordinator

                                              1110 Friendly Pines Road

                                              Prescott, AZ 86303
Last Name:    First Name: 
Address: 

City:       State: Zip: 

Email Address: 

Age Race Day:       Phone:

Gender:  Me  F

 

Event	Through 09/17/2008	After 09/17/2008
10K	$25.00	$30.00
5K	$20.00	$25.00
2 Mile Fun Run/Walk	$20.00	$25.oo

Entry Fee (from table above):  

Event: 10K  5K  2 Mile Fun Run/Walk

T-shirt Size:  S M  L   XL 

Please read the waiver and sign the form. Thank You.

RELEASE FORM (MANDATORY): All applications MUST be signed to enter this event. No entry accepted without fee. NO REFUNDS.

WAIVER: In consideration of accepting this entry, I the undersigned, intending to be legally bound hereby, for myself my heirs, executors, and administrators waive and release any and all rights and claims for damages I may have against the Arizona RunningEvents Co., Groom Creek Fire District, Friendly Pines Camp, American Red Cross or anyone associated with this event, their representatives, successors and assigns for any and all injuries suffered by me in said event.  I will additionally permit the free use of my name and pictures in broadcasts, telecasts, newspapers, etc.

Signature:__________________________________________ Date:__________

Parent or Guardian's signature (if under 18 years of age)