5th Annual
5K Run For Reading and Walk For Literacy

October 11, 2003
8:30 a.m.
Carlyle Lake - Dam West Access

WAIVER OF LIABILITY

(To be signed by all race participants.  Parent or legal guardian must also sign if participant is under 18.)

I am voluntarily participating in the above event and hold Kaskaskia College and all sponsors harmless from any and all liability, damages, judgments, costs, and expenses, including attorneys’ fee, arising or growing out of my participation in the above event.  I further understand that entry fees are non-refundable. 

CHECK ONE:    WALK ____  RUN: 1 Mile ___  5K ____    Signature:___________________________________________

PLEASE PRINT

Name __________________________________________       Male ___    Female ___   Age of Race Day _______

Address ________________________________________      City/State/Zip ______________________________

Telephone _______________________        T-shirt size: (circle one) S      M     L     XL      XXL  (subject to availability)