Laserfiche WebLink
<br />Apr 24 09 08:31a <br /> <br />Catherine Branch <br /> <br />703-323-4964 <br /> <br />p.11 <br /> <br />Festival of the Lakes 8K Salll,day, Aug a. 2009 8 AM Rm Stan I <br />Centerville, Minnesota UM_ Park Centerville, MN <br /> EIlllyh<$lS pri",!C}u,.,6, 2009, $20J... 6.Aug 6, S2S on <br /> _day. Ra:e day rcgisualioo 7 AM. <br /> Drop otI or mail to City cr CenterviUe I SSG Mllin S\l'<el I <br /> cen_m.. MN 55038 I <br />..1 I I I I I ..1 J ( I I I 1 J I I I I 1 I I I I I <br />First Name . Lasl Name I <br />~ J I I I I I I I i I I I I -.l I I XSISIMILIXL ' XS <br />e-mail address 5hirtSite <br />j J I II I I I I I I I I I I f I M I F <br />AddRl$$ Sex Aao <br />J I I I I -.l _L I I I I : I I I I I <br />ZlPCO<Ie City Stale <br />J I I - ; I _L -I j I I I I ..l I I I I I <br />PIIone N.~ <br />I , I I I I - I I I I I - I I I ! I - I I I / I I <br />Me VISA Credit Cord Number <br />-.l I I l-.l I I I I I -.lJ. I I I I I I I I I <br />Expiration Date Card Hoidefs Signature <br />Make CheckS Pawabloto tho City, of CantoN'"" <br />J tnDW lhat nmniog a road race is a potentiaJty hEtZardOV5 acth'it)' and tbat I should not enter and run unless] am medically able and <br />properly trained. J agree 10 abide by any decision ofa raee official rdative to m). ebiJity to safely completo the run. I assume all risk <br />associate with running. m 1hi:s. ~cot iacludiog. but tKt litnited 10: fails, contact with other particjpanfs. the effects ofwesthcr? inclading <br />high: IRt and/or bwnidit)', traffic and the oooditions of the road, aU such risk being koown and apprecioled by me. Having ~ad this <br />waiver and knowing these facts 8Dd in oonsidetat:iOh of your accepting my entJy. 1, r~ myself and anyone entitled Ul act Oft my behalf, <br />WlIM and release tho ctgllDi:zm oflbe Festival crib. Lok., 8K, Cityof Cal_ilk, USA IF, and all sponsors mm all claims or <br />liabilities of any kind arising {Jut of my participlllion. in. this event or carelessness on the part oftllc persons named in tIli.s waiver, <br />Further, I gr.ant permission to aU of the foregoing 10 use any photographs, motion piclurts. recording. OJ o\bcr record of"this event for <br />legitimate pu<poS<S. <br />Sisnat= (_I'" guardian ij"undet 18) Date <br /> I <br />