Mission Mozambique 5K Run/Walk

8:15 AM . Saturday . April 5, 2008

To raise money for missions to Mozambique
What: A 5K run/walk race created to raise money for a missions trip to Mozambique

When: The race will be Saturday, April 5th at 8:15 AM.

Where: Link Trail and Mike Lewis Park in Grand Prairie (2600 North Carrier Parkway)

Entry Fee and Registration: $20 (includes t-shirt). Mail this form and fee (money orders only
please) to Stephanie Brasher. 3000 Mountain Creek Parkway. Dallas, Tx 75211. (Please mail by
3/24/08) Or you can register at The Runner Shop (3535 W. Pioneer Parkway. Arlington, Tx
76013. Phone: 817-461-2281). Packet pick-up will begin April 2nd at The Runner Shop.

Questions: Please visit www.stephanieinafrica.wordpress.com for more information or email

Stephanie_in_Africa@yahoo.com
----------------------------------------------------------------
Mission Mozambique Registration and Release Form
To register for the 5K Run/Walk, fill out this form and take it with cash or money order to The Runner in Arlington.
Please submit a
separate form for each entrant (copies accepted). Entries submitted without signature and payment WILL NOT be
processed.

Name:______________________________________________________________________

Address:____________________________________________________________________

City: _________________________________________State: _______ Zip: ______________

Phone (day): __________________________ (evening): _____________________________

E-mail address:_______________________________________________________________

Age as of 4/4/08:______Gender: Male _____ Female_____ T-shirt size (s/m/l/xl):______

Race waiver and Release (Must be signed by each entrant)

I FULLY UNDERSTAND I AM FOREVER GIVING UP IN ADVANCE ANY RIGHT TO SUE OR MAKE ANY CLAIM AGAINST THE
PARTIES I AM RELEASING IF I SUFFER SUCH INJURIES OR DAMAGES EVEN THOUGH I DO NOT KNOW WHAT OR HOW
EXTENSIVE THOSE INJURIES AND DAMAGES MIGHT BE AND AM VOLUNTARILY ASSUMING THE RISK OF SUCH INJURIES
AND DAMAGES.I WILL ASSUME MY OWN MEDICAL AND EMERGENCY EXPENSES IN THE EVENT OF AN ACCIDENT OF
OTHER INCAPACITY OR INJURY RESULTING FROM OR OCCURING IN MY PARTICIPATION.

Signature of Entrant ________________________________________ Date ______________

Signature of Parent or Legal Guardian (if under 18) ___________________________________