The Annual 5K C.O.R.E. Run and 1Mile Fun Walk

C.O.R.E. annual 5K run and fun walk.
FIRST NAME _________________________
LAST NAME__________________________
GENDER: M F (OTHER__________)
AGE _______
BIRTHDAY____/_____/_____
E-MAIL: _________________________
ADDRESS_________________________________
CITY _________________________
STATE________________________
ZIP CODE ____________________
PHONE_______________________

T-shirt Size: YS YM YL S M L XL XXL

No T-shirt

Amount Enclosed (see pricing): ____________

Cash or check preferred. Mail forms to: CORE, POB 435 Sidney, Ohio 45365.

I, for myself, heirs and assignees, hereby release CORE, Tawawa Park, all sponsors, coordinating groups, and any individuals associated with this event and their representatives from any and all claims that may arise as a result of my participation in the CORE 5K Run. I certify that I am physically fit and assume all risks associated with my participation.

Signature:_______________________________

Parent or Guardian Signature: _________________________________________

must sign if participant is under 18 years of age

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