date: saturday, april 24th

time: 9 am

location: in front of the usu fine arts building

contact: kathy puzey at kpuzey@gmail.com or (435) 797-3849

participant info:

name:_______________________________________________________

address:____________________________________________________

city:_______________________state:_________zip______________

phone:__________________________

e-mail:_____________________________________________________

gender (circle one) M F

t-shirt size (circle one) S M L XL XXL

payment info: (circle one)

st
early bird registration(by april 21 ) day of race registration(7- 8:30 am)

$10 for students $15 for students

$15 for community $20 for community

wavier: In consideration of your acceptance of this entry form, I hereby release the sponsors, officials, owners of
the facilities used for this race and any and all groups, people or facilities connected with USU Print Sprint for
any and all injuries by me at said race. I further certify that I am physically fit to participate in the run. I hereby
grant full permission to any and all of the foregoing to use any photographs and recordings or any record of this
event. In the event of cancellation due to severe weather, please consider my registration fee a donation to the
USU Print Guild.

signature:_____________________________________________________________

please send your completed registration form & entry fee to:
Kathy Puzey/USU Art Department/4000 Old Main Hill/Logan, UT 84322