ArkansasRunner.Com

Need T-shirts for your race or running club?


----------
 Miles for Missions 5K/1.5M
Entry Form
April 19, 2008 -- 8:00am -- Little Rock, AR
Go to http://www.phumc.com/MilesForMissions.htm for course details
Name:
Last:                                                                     First:

Date of Birth:                           Sex:      M     F                   Age on 4/19/08:

Address:                                                                            Email:

City, State, Zip:

Shirt Size:
Adult:          S          M             L             XL          XXL
Youth:         M         L


Circle One:          5K Run          1.5M Family Fun Run/Walk          5K Virtual Runner

Release:
I know that running and volunteering to work in club races are potentially hazardous activities. I should not enter and run in this race unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I assume all risks associated with running and volunteering to work in club races including, but not limited to falls, contact with other participants, the effects of the weather, including high heat and/or humidity, the conditions of the road and traffic on the course, all such risks being known and appreciated by me. Having read this waiver and knowing these facts, and in consideration of your accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release the PHUMC Miles for Missions 5K, Pulaski Heights United Methodist, the city of Little Rock, ArkansasRunner.Com, and all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in the race and/or club activities even though liability may arise out of negligence or carelessness on the part of the persons named in this waiver.  I grant permission to all the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for any legitimate purpose.

Signature:                                                                                                          Date:

Parent Signature if under 18 years:                                                                   Date:


Make checks payable to Pulaski Heights United Methodist Church and mail to:
Miles for Missions
c/o Cindy Burns
4823 Woodlawn Avenue
Little Rock, AR  72205


Fees:
5K and Virtual Runner:  Pre-registered $20, day of race $30
1.5M Family Fun Run Walk:  Pre-registered $15, day of race $20, Family maximum $45 pre-registered, $60 day of race

For information, call 501-664-3600