2013 9-11 MEMORIAL EVENT

OFFICIAL RUN ENTRY FORM

HALF-MARATHON AROUND PELAHATCHIE BAY 1 MILE CHILDREN'S FUN RUN

NAME: ________________________________________________________________________________ AGE ON RACE DAY:_____________ ADDRESS:_____________________________________________________________________________ CITY: ________________________________________________________________________________ STATE: _______________________ ZIP: __________________ PHONE: ____________________________ E-MAIL: _____________________________ SHIRTS: (Adult) S M L XL XXL (Youth) S M L XL
(Children's Fun Run does not include t-shirt)

T-Shirts guaranteed for first 200 registrants Featuring our heroes in uniform, supporting the Mississippi Burn Foundation. *Races* *Food* *Entertainment* *Prizes* September 8, 2013, Lakeshore Park, 1:30 p.m. 5:30 p.m. (next to Reservoir YMCA, 6023 Lakeshore Park, Brandon, MS, 39042) Firefighters and other Heroes begin at 1:30, Half-Marathon begins at 2:00, Childrens Fun Run begins at 4:30 $25 for Half-Marathon; $10 for Children's Fun Run Make checks out to: Mississippi Burn Foundation Memorial Run Mail to: Stinky Feet Athletics 153 Ridgeway, Suite C Flowood, MS 39232

Sponsored by Reservoir Fire Department St. Mark's United Methodist Church, Stinky Feet Athletics, and the Pearl River Valley Water Supply District.
Additional information and on-line registration: www.stinkyfeetathletics.com/911-half-marathon
I realize that running a road race is a potentially hazardous activity. I should not enter and run unless I am medically able and properly trained. I assume all risks associated with running in this event 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 2013 9-11 MEMORIAL EVENT and all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this 11 mile run and children's fun run.

Signature
(of parent if under 18)

Date

g:troy/miscellaneous/9-11 Memorial Run