Fallsburg Entry Form

  Mail this page with a check payable to:

          OLD FARTS RUNNING CLUB

                  2010 WOODRUN

                 LOWELL, MI, 49331

Print Name:______________________________________

Address:________________________________________

City:___________________State:_______Zip:__________

Age on Race Day:________ Date of Birth:______________

Gender: circle one:   male   or   female

Email Address:____________________________________

PHONE #: _______________________________________

Each pre-registered race entrant will be put on line on the web page under race entrants to show that your entry has been received and accepted.

CIRCLE THE RACE THAT YOU WISH TO SIGN UP FOR:

FULL MARATHON  26.2 MILES  (no entry limit but no race day registration for marathon only)

EARLY BIRD SPECIAL...SIGN UP BY JAN. 1ST COST IS ONLY  $40.00

Cost is $60.00 up to August 1st

August 2nd till race day $75.00

Circle Sweatshirt Size:    small   medium   large   x-large   xxlarge

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HALF MARATHON  13.1 MILES

Cost is  $25.00 up to August 1st

There is race day registration...cost is $30.00 T-shirts guaranteed for all pre-registered runners...and first come first serve on race day

Circle T-shirt Size:  small   medium   large   xlarge   xx large

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The PRE 5K  ( 3.1 miles)

Cost is $15.00 up to August 1st

$20.00 race day registration..tees available while they last on race day

Sad to be Called a T-shirt Size:   circle one:    small   medium   large   x-large

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FALLSBURG MARATHON, HALF, AND 5K RACE WAIVER...

WAIVER MUST BE SIGNED IN ORDER TO BE FULLY ACCEPTED. IN REGISTERING FOR THIS RACE I STATE THAT I AM FULLY AWARE, UNDERSTAND, AND ASSUME THE RISK AND RESPONSIBILITY FOR PARTICIPATING IN THIS RACE ON A COURSE WITH VEHICULAR TRAFFIC AND THAT I HAVE FULLY CONDITIONED MYSELF TO THE APPROPRIATE LEVEL OF FITNESS. I ALSO WAIVE ALL CLAIMS AGAINST THE RACE DIRECTORS, HOST SITE, SPONSORS, THE CITY OF LOWELL, ETC. AND THAT I AM AWARE OF THE FACT THAT IF THE RACE GETS CANCELLED DUE TO WEATHER OR OTHER REASONS THAT THE RACE ENTRY IN NON-REFUNDABLE.

SIGNATURE:____________________________ DATE:_________________________

PARENT or GUARDIAN MUST SIGN IF UNDER 18 YEARS OF AGE:

_______________________________________DATE:__________________________