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Saturday, April 28, 2007 -- Morgantown, WV
Parents Place 5K - MAGP Sprint #2 (iPO Event Id#: 10009)

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Early Registration: $12.00 MUST BE POSTMARKED BY APRIL 14th! Race Day Registration: $15.00 - Make checks payable to: Parents' Place
Mail to: Parents' Place, 312 Jackson Avenue, Morgantown, WV 26501

Name:______________________________________ Phone:_____________________

Address:__________________________________________ Date of Birth:_________
Age as of 4/28/07:________  Male:___ Female:___

T-shirt size Small:___     Medium:___     Large:___    X-Large:____

Please check your choice for the event:  Running_________   Walking__________
In consideration of your acceptance of my application for entrance in the Parents' Place 5K, I, for myself and anyone entitled to act on my behalf, waive and release Parents' Place and all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event. I release any photos that may involve myself:

Signature: ________________________________________ Date____________

Entrant's Signature Parent of Guardian, if under 18:

Signature: ________________________________________ Date____________