Sallie Mae 10k Registration
Payment Info - You may pay by check, money order, or Visa/MasterCard
$20 - On or before April 22, 2003
$25 - After April 22, 2003
$12 - Under 18 and college students (copy of Student ID required)
$10 - Fun Run
Fax:202-296-6341 (credit card required)
Mail to (Make checks payable to Sallie Mae 10k):
SallieMae 10k
13710 Ashby Rd.
Rockville, MD
20853-2903
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First Name Sex
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Last Name
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Address
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Apt/Suite Phone Number
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City State
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Zip Age Birth Date(MM/DD/YY)
T-shirt Size: S M L XL
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Email Address
Category: 10k ____ WheelChair ____ Fun Run ____
Team Category*: All Male ____ All Female ____
Mixed ____
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Intercollegiate Team Name/School Name
The 2003 Sallie Mae 10k will be using ChampionChip timing technology.
____ I will be using my own ChampionChip in the race, and here is my
chip # ________________________________________________________
All ChampionChip owners may subtract $1.00 from their race entry fee.
FORM OF PAYMENT:
____ Check ____ Money Order ____ Visa/Master Card
_________________ ________________________________________________
Total Amount Paid Visa/Master Card #
_________________ ________________________________________________
Expiration Date Signature
(MM/YY)
Please Sign the waiver before mailbag!
I know that running a race is a potentially hazardous activity and that 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 voluntarily assume all risks associated with running in
this event and parcticipating in any awards ceremony thereafter (collectively, the "Event"),including, but not limited to:falls, contact with other participants, the effects
of the weather, including high heat and/or humidity, traffic and the conditions 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, voluntarily waive,release, and covenant not to sue the organizers
of the Sallie Mae 10k, SLM Holding Corporation and all of its subsidiaries, Brotman-Winter-Fried Communications, Inc.,other management companies, sanctioning organizations, beneficiaries
and all other sponsors, their representatives and successors (collectively, the "Releases") from all claims or liabilities of any kind arising out of my participation in the Event or
carelessness on the part of the Releases. Further, I grant permission to the Releases to use any photographs, motion pictures, recordings, or any other record of the Event containing my name, likeness, or performance.
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Signature Date
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Parent's Signature if under 18 years Date
