ENTRY FORM INSTRUCTIONS:
1. Type the information in the blanks
2. Print this entry form.
3. Read the printed legal disclaimer.
4. Sign the entry form.

5. Mail in the signed entry form and your entry fee to:
Delaware Running Co
Greenville Shopping Center
Greenville, DE 19807
RACE ENTRY FORM
Name of Race:
Distance: Walk Run
Entry Fee: $
Race date: Month / Day / Year
Team/Club: (if applicable)
Name:
Address:
City:
State:
Zip:
Telephone:
Email: Yes, add me to e-list
Gender: Male Female
Date of Birth:
T-Shirt size: S M L XL
In consideration of this entry being accepted, I, intending to be legally bound, hereby for myself, my heirs, executors, administrators, waive and release all rights I may have against the organization holding this event, its agents, representatives, successors and assigns for any and all injuries suffered by me at said race.

Signature: _____________________________________________________________________
Date: _________________________