Saturday, June 19, 1999 -- Bridgeport
Burger King WVIHF 5K

Make checks payable to: WVIHF

Mail entry forms to:
WVIHF
P.O. Box 1632
Clarksburg, WV 26302-1632

Click here to return to the race Details Page

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NAME_________________________________________________


ADDRESS_______________________________________________


CITY____________________________STATE______ZIP_______


DATE OF BIRTH____/____/____     SEX____________

AGE ON RACE DAY_____________

SHIRT SIZE: S____  M____  L____  XL____

WAIVER: In consideration of acceptance of this entry to Burger King WVIHF 5K Run,I waive all claims for myself, my heirs and assigns against the race sponsors, promoters, or officials due to injury or illness which may result from my participation. I attest and verify that I have full knowledge of the risk involved in these events. I am physically fit, and sufficiently trained to participate. I have read the above statement, I understand it, and my signature confirms its full acceptance.

SIGNATURE____________________________________________________

DATE_________________ 

PARENT/GUARDIAN IF UNDER 18__________________________________