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3rd
Annual
Chattahoochee Soccer vs. Centennial Soccer Alumni
5K Fun Run/Walk
SATURDAY, March 13, 2010
Benefitting: STAR House
Foundation
as well as the soccer booster clubs of Chattahoochee and
Centennial
High Schools.
RUN/WALK
Begins at
11:00 a.m.
(check-in starts at 10:00 a.m.) at stadium of Centennial
High School, 9310 Scott
Road, Roswell GA 30076.
Entry
fee:
$20 for each
participant
·
On-line
via PayPal (credit/debit card) in advance
by midnight,
Friday, March 12
If name on Paypal email account differs from runner’s name,
or paying for more than one runner, PLEASE also send email to
centsoccer@gmail.com so we can match payments/runners.
We
will also accept
Checks
payable to either “Centennial Soccer Booster Club” or
“Chattahoochee Soccer Booster Club” OR
Cash
on day of the event only.
Print and bring this signed form to event with you.
Race
numbers: will be distributed at check-in Saturday morning.
T-Shirt Size: (circle) : Small –
medium –
large – extra large
Release and Waiver of Liability:
must be read,
signed, and returned with payment or on day of event:
The
undersigned hereby acknowledges that participation in this run
and related activities involves an inherent risk of physical
injury, and the undersigned, on behalf of the registrant, hereby
assumes all such risk and does hereby release and forever
discharge the school and all employees and agents thereof from
any and all liability of whatever kind and nature, arising from
and by reason of any and all known and unknown, foreseen bodily
and personal injuries, damage to property, and the consequences
thereof, resulting from this registrant’s participation in and
or involvement with this event, including any failure of
equipment or defect in the premises. I hereby state that I am a
legal guardian of said child.
Signature of
runner (or parent/guardian if runner is under 18 years of age):
_________________________________________________________Date________/2010
Printed name
of RUNNER __________________________________________________
Printed name of
parent/guardian:________________________________________________
Address & Phone
____________________________________________________
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