REGISTRATION FORM
Sponsored
by Hartford Lions Club with all proceeds benefiting Hartford
Boy Scout Troop 32
Print, fill
out and return this entry form with registration fee made out
to Hartford Lions Club.
In consideration of
my acceptance in the Winston Howell 10,000 Meter Road Race, I
waive any and all claims for myself and my heirs against officials
or sponsors, City of Hartford, Hartford Lions Club and Boy Scout
Troop 32 for injury or illness which may directly result from
my participation in the race. I further state I am in proper
condition to participate in this event.
Name ____________________________________________________
Sex ________ Age as of 3-8-08________
Address _________________________________________
City _________________State______ Zip_________
Signature in full:
_____________________________________________ Email: __________________________
Signature of parent
or guardian (if under 18): _______________________________________________________
Check one: [ ] Run
[ ] Walk
Return form
with $20 entry fee made out to "Hartford Lions Club"
to:
Cary Hatcher, P.O. Box
158, Hartford, AL 36344
334-588-2343 (FAX 334-588-6192)
hatch@alaweb.com
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WINSTON HOWELL 10,000M ROAD RACE