Brickfest 5K Malvern, AR June 28, 2008 7:30 AM
ENTRY FORM - PLEASE PRINT	Grand Prix Website: www.ArkRRCA.com
Name: Last:	First:
Date of Birth:	Age on June 28, 2008:
Sex:     M       F
Address:
City, State, ZIP:
Check One:             ____5K Runner              ____5K Wheelchair             ____5K Walker
Shirt Size:             S              M              L              XL
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 Malvern Runners, the City of Malvern, the RRCA, and all sponsors 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:
Parent Signature if under 18 years old:
Date:
Entry Fee: $15 preregistered; $20 day of race Students (18 & under): $7 (includes shirt) Make checks payable to Malvern Brickfest 5K and mail to: Malvern Brickfest 5K c/o Linda Wood 6776 Hwy. 270 Malvern, AR 72104