Spooktacular 5K - Saturday October 25th, 2008

Make checks payable to: GFLRRC
Mail to: Spooktacular 5K, PO Box 2512, Ft. Lauderdale, FL 33303-2512
For best results, set page margins to zero before printing.
    
 
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E-mail

___________________________________  ______________________   ________      (  ) (  )
Last Name                            First Name            Age on Race Day  Male Female

________________________________________________________________________
Mailing Street Address (Indicate Apt. No. and /or C/O)

_________________________________   ______________________   _____________
City                                State                     Zip Code

              ______   ______   ___________   _____________________________________
Birthdate     Month     Day      Year         Telephone

Entry Fees                Pre-Reg      Race Day    Event
GFLRRC Members              $20.00        $30.00     5K Fitness Walk           (   )
Non-Members                 $25.00        $30.00     5K Run                    (   )
19 & Under                  $10.00        $30.00     Spooky Sprint Kids Dash   (   )
Spooky Sprint Kids Dash      $3.00         $5.00     Monster Mile              (   )
Monster Mile                 $3.00         $5.00      *No t-shirt for Kids Dash or Monster Mile
                                                                                                                                              
T-Shirt Size Small ( ) Medium ( ) Large ( ) X-Large ( )
   
Release Form (Mandatory)
In consideration of accepting this entry, I, the undersigned, intending to be legally bound hereby,
for myself, my heirs, executors and administrator, waive and release any and all rights and claims
for losses and damages I may have against the Greater Fort Lauderdale Road Runners Club, race
directors, their officers, directors, members and volunteers, any and all sponsors including other
parties and their representative successors, and assigns for any and all injuries suffered by me in
said event. I attest that I am physically fit and have sufficiently trained for the competition of
this athletic event and competition which I am voluntarily entering at my own risk. My physical
condition has been verified by a licensed medical doctor. Further, I hereby grant full permission
to any and all foregoing to use photographs, videotapes, motion pictures, recordings or any other
record of this event for any purpose whatsoever.
USE OF HEADPHONES, OR ROLLING SKATES / INLINE SKATES, BABY JOGGERS ARE NOT PERMITTED ON THE COURSE.
NO ONE MAY ENTER THIS EVENT WITHOUT SIGNING THIS OFFICIAL WAIVER.
   


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Signature    Date   /   Signature of Parent or Legal Guardian if Under Age 18    Date