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KALAMA RIVER RUN REGISTRATION FORM
NAME _____________________________________________________________
AGE _________ SEX _________ BIRTHDATE _________________________
ADDRESS __________________________________________________________
CITY/STATE/ZIP _____________________________________________________
PHONE _____________________________________
________________________________
PRE-REGISTRATION ENTRY - $10.00
PRE-REGISTRATION W / T-SHIRT - $20.00
ENTRY AT RACE - $12.00
ENTRY AT RACE W/ T-SHIRT - $22.00
CVR MEMBERS $2.00 OFF
CHILDREN 12 AND UNDER $5.00
T-SHIRTS - ALL ADULT SIZES
INDICATE T-SHIRT SIZE: M _______ L _______ XL _______
RELEASE
ASSUMING ACCEPTANCE OF THIS ENTRY – I, FOR MYSELF, MY HEIRS AND EXECUTORS, HEREBY RELEASE THE KALAMA RIVER RUN COMMITTEE, KALAMA FAIRGROUNDS OPERATORS, KALAMA COMMUNITY FAIR, AND ITS BOARD MEMBERS, COWLITZ VALLEY RUNNERS AND ALL EVENTS SPONSORS FROM ANY AND ALL LIABILITIES ARISING FROM ANY ILLNESS, INJURY OR DAMAGE I INCUR AS A RESULT OF ANY PARTICIPATION IN THIS EVENT.
___________________________________________________________________________
SIGNATURE (PARENT OR GUARDIAN MUST SIGN IF ENTRANT IS UNDER 18 YEARS OF AGE)
DATE __________________________________________
This form may be printed out and mailed to Kalama Community Fair, PO Box 546, Kalama, WA 98625, or copy the information into an email message and email it to Laurie Merwin at llmerwin@longfibre.com. If you have any questions, please call Laurie at (360) 430-3029.
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