8/29 Race Mt. SAC - So Cal Roadrunners

• Sunday August 29 SCCR Race
• 8:00 A.m. start
• SCRR’s Strive for Knowledge/Funds for College
• $17.00 entry fee
• 3-Mile Race – Mt. SAC Course, Walnut CA

Please print this page or follow this link >http://www.active.com/register/index.cfm?event_id=1140611&site=header

SOUTHERN CALIFORNIA ROAD RUNNERS OF WALNUT PRESENT

STRIDE FOR KNOWLEDGE FUNDS FOR COLLEGE At MT. SAN ANTONIO COLLEGE CROSS COUNTRY COURSE AUGUST 29, 2004 at 8:00 AM

• REGISTER BEFORE 8/20/04 -----$17.00 REGISTER AFTER 8/20/03-------- $20.00 CHILDREN 8 & UNDER ----------$10.00
• WOMEN’S RACE -----8:00 AM MEN’S RACE---8:30 AM CHILDREN’S FUN RUN ---9:00 AM

Race will be on the Cross Country Course at Mt. SAC College: Thomas Guide LA Pg. 639-G4

• MAKE CHECKS PAYABLE TO SOUTHERN CALIFORNIA ROADRUNNERS OF WALNUT, INC.
• MAIL COMPLETED ENTRY FORM AND FEE TO
• SOUTHERN CALIF. ROADRUNNERS C/O RITA HOGAN, 3906 TURQUOISE LANE LA VERNE, CA 91750
• Or Register ONLINE at http://https://www.active.com/register/index.cfm?event_id=1140611&site=header

AWARDS 3 DEEP IN EACH DIVISION OVERALL MALE & FEMALE WINNERS WIN A PAIR OF SHOES FROM TOP SPEED RUNNING STORE OF LA VERNE

For more information about this race, call (626) 622-8569 or (626) 347-8728

First Name: __________________________Last Name ______________________________________

(Please Print)

Address: ___________________________________________ Phone: (____) __________________________________

City _________________________________________ State: _________ Zip: ______________ T Shirt Size: S M L XL

Female_____ Male______ Age on Race Date: _________ Amount Enclosed: ____________

Circle one:

9 and Under ----- 10–14 ----- 15-19 ---- 20-24 ---- 25-29 ---- 30-34 ---- 35-39 ---- 40-44 ---- 45-49

50-54 ---- 55-59 ---- 60-64 ---- 65-69 ---- 70 and over

Waiver: In consideration of your accepting my entry, I the undersigned, intending to legally bind myself and my heirs, executors, administrators, next of kin and assignees, do hereby waive any and all rights and claims against any person or organization affiliated with this race. I agree to indemnify and hold harmless the SOUTHERN CALIFORNIA ROAD RUNNERS OF WALNUT, officials, the race organizers and any and all sponsors from any claims, actions, damages, liability and expenses, including attorney’s fees, on account of injury to my person or property or resulting in my death while I am competing, observing or participating in any way in this event, including travel to and from the race. I further attest that I am physically fit and have been sufficiently trained for the race that I am entering and that my physical condition has been verified by a licensed medical doctor

SIGNATURE ___________________________________DATE _______________________________

SIGNATURE OF PARENT IF PARTICIPANT IS UNDER 18