Transcript Document
April 28, 2012 in front of Boyd County Courthouse 2800 Louisa Street, Catlettsburg, Kentucky 8:00 a.m. On-Site Registration and 9:00 a.m. Race $15.00 if pre-registered before April 21, $20 Day of Event Course: Short Sleeve Shirts Guaranteed to first 150 participants Goody Bags, Door Prizes & Refreshments Fast and flat through downtown Catlettsburg and over and back on the Billy C. Clark bridge into Kenova, West Virginia. Take the bridge challenge and run in two states in one race! Please mail registration and check payable to: CASA Boyd County Courthouse 2800 Louisa Street, Suite 202 Catlettsburg, KY 41129 606.739.2177 Phone Carol Adams, Director - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -CUT OFF - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Name:_____________________ Address:_______________________ Email:______________________ _____________________________ Phone:___________________T-Shirt Size Youth- M L Adult- S M L XL 2X Age Category (circle one):14 & under 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75 & over Gender: M F Age on Race Day:______ WAIVER: I know running a road race is a potentially hazardous activity and I should not enter a run unless I am medically able and properly trained. I agree to abide by any decisions of a race official relative to my ability to safely complete the run. I assume all risks associated with running in this event, including but not limited to, falls, contact with other participants, the effects of weather (including high heat or humidity), traffic and the conditions of the road, all such risks being known and appreciated by me. Having read this waiver, I release CASA of Northeast Kentucky, Inc., race officials, volunteers and all sponsors from all claims to liabilities arising out of my participation in this event. Signature:_______________________________________________________________ Date:____________ Parent/Guardian Signature (Required for Minor)___________________________________ Date:____________