View Application - NorthernRunner.org
Transcription
View Application - NorthernRunner.org
Massena Central School Class of 1981 5K Walk/Run Proceeds to benefit: Massena Meals on Wheels and the Massena Humane Society Date: July 2, 2011 Time: 9:00 a.m. Pre-register by: June 1, 2011 Entry fees: $15 per person pre-registered $17 per person on race day Please make checks payable to: MCS Class of 81 Entry fee includes free commemorative t-shirt for the first 50 registrants. Walk-Run will be comprised of two laps around the John Story Trail that encompasses the Massena Central High School. Registration begins at 8:00 a.m. near the Central Administration Building (former bus garage). The CASP-E-R Massena Central School District Assumption of Risk and Release of Liability Form MUST BE COMPLETED in order to participate in the walk/run. For more information and to register, call: Lisa (Proulx) Bell at 315-769-5810 or via email: [email protected] Mail registration form, waiver and fee to: Forms are available online at the following link: http://mcs.k12.ny.us/casper_liability.pdf Name Address Lisa Bell 9 Dover St. Massena NY 13662 Phone: 316-769-5810 Email: [email protected] Phone T-shirt Size: Gender S M L XL Age on race day Signature Date Signature of parent or guardian if under 18 years of age. Date