Mayo Clinic Corporate Challenge Fill-in Entry Form
March 3, 2001
Instructions to enter:
Complete and Print this form (using your browser Print button); enclose the appropriate entry fee (checks payable to Mayo Corporate Challenge); mail to or drop off at:
Mayo Clinic Corporate Challenge
c/o Runner's Den
6505 N. 16th Street
Phoenix, AZ  85016
Entries cannot be accepted unless all fields denoted with * are completed.
*Event - 8K Run 5K Walk 1 Mile Fun Run 8K Inline Skate Aerobic Jam:
*Last Name *First Name
Address City State Zip
Day Phone Birthday (mmddyy) *Sex (m/f) *Age T-shirt(m/l/x)
Fax
I am participating as a member of a Team (select one below)
Corporate: School: Open:
Company/Team Name Team Captain
Phone # E-Mail Fax #
Waiver (please read and sign): In consideration of your acceptance of this entry, I hereby, for myself, my heirs, my executors, and administrators, hereby waive any and all rights and claims for damages I may have against the sponsors, coordinating groups, and any individuals associates with the event, their representatives, successors, and assigns, and will hold them harmless for any injuries suffered in connections with said event. Also, none of the above are responsible for the loss of personal items nor any other form of aggravation in connection with said event. I have been warned I must be in good health and prepared to participate in this extremely physically demanding event. In filling out this form, I acknowledge I have read and fully understand my own liability and do accept the restrictions.

___________________________________________________________________________
Entrant's Signature (Parent's, if entrant is under 18)