Runner's Den Classic Road Races Fill-in Entry Form
January 28, 2000
Instructions to enter:
Complete and Print this form (using your browser Print button); enclose the appropriate entry fee
(checks payable to Runner's Den Race); mail to or drop off at:
Runner's Den Race
6505 N. 16th Street
Phoenix, AZ  85016
Entries cannot be accepted unless all fields denoted with * are completed.
*Event - 10K Run: 5K Run: 1 Mile Fun Run: 5K Walk:
10K Inline Skate: 5K Family Skate:
*Last Name: *First Name:
Address: City:
State: Zip: Day Phone: Birthday (mmddyy):
*Sex (m/f): *Age: T-shirt(m/l/x): 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.

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