Name: 
      Address: 
         City: 
        State:    Zip: 
        Phone: 
Date of Birth:    Age on race date: 
       Gender: M F 
    Expect Me: January 12  January 26 February 9  

Free (Children up to 8th grade)

Enclosed is $ 3 per meet x meets (high school students) ($ 9 for all three meets)$

Enclosed is $ 4 per meet x meets (DCRRC or PVTC members) ($ 12 for all three meets) $

Enclosed is $ 5 per meet x meets (all others) ($ 14 for all three meets if received by December 31) $

To help keep these meets free for children, here is a donation of $

Donations to D.C. ROAD RUNNERS CLUB are tax-deductible under §501(c)(3).

I will help as a volunteer. Please call me. ESPECIALLY NEEDED: TIMERS IN THE 55-METER -- 8 am to 9 am

For more info, visit: http://pvtc.org/timers.htm or e-mail RACEDIRECTOR@ATT.NET

Waiver Must Be Read and Signed Before Mailing:

I know that running a road race is a potentially hazardous activity. I should not enter and run unless I am medically able and properly trained I agree to abide by any decision of a race official relative to my ability to safely complete the run. I assume all risks associated with runnimg this event, including but not limited to contact with other participants, effects of the weather including high heat and/or humidity, traffic, and the condition of the road, all such risks being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of your accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release the organizers and sponsors of the Indoor Track Meets and DC ROAD RUNNERS and any other sponsors and their representatives and successors from all claims or liabilities of any kind arising out of my participating in the event even though liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I grant permission to all the foregoing to use any photographs, motion pictures, or any other record of this event for any legitimate purpose.

_______________________________  _____________ _____________________________________

Signature                        Date          Parent's Signature if under 18

From www.racePacket.com, Thanks for your support.