ENTRY FORM

Subway Capitol 5000 - June 9, 2001
Please enter me in . . . (please check one)
People's Race (5K) $15 by June 1 or $19 thereafter
Silver Classic (5K) $15 by June 1 or $19 thereafter
1 Mile Fun Run/Walk/Ticker Walk $6 by June 1 or $8 thereafter
1/3 Mile Kids' Run for Children under 8 years old $6 by June 1 or $8 thereafter
Team or Corporate Team (All entries must be sent together) - 3 runners per team
Under 18 team
Name:                     

Age

       

Sex

       

Birth Date:

      
Street Address                      

City

                    
State        

Zip        

Telephone (with area code)

                    
Previous Best Time         minutes        seconds

year       
 
I know that running the 5K run is a potential hazardous activity.  I should not enter and run unless I am medically able and properly trained.  I agree to abide by any decision of a race official relative to my ability to safely complete the run.  I assume all risks associated with running the event including, but not limited to: falls, contact with other participants, the effects of the weather, including high heat and/or humidity and cold or slippery conditions of the race course, all such risks being known and appreciated by me.  Having read this waiver and knowing these facts and in consideration of your accepting my application, I for myself and anyone entitled to act on my behalf, waive and release the race director, race officials and volunteers, any and all sponsors including, but not limited to all their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event. Waive and release to the I.O. Silver Games the right to use photographs taken at this event.
                                                               
Signature Co-Signature (Parent/Guardian must cosign if applicant is under 18 years of age)
                   
Shirt Size (subject to availability after June 1st)
please check one:		 Total amount enclosed: $             
small medium Please make check payable to I.O. Silver Games and mail to:
I.O. Silver Games, 1844 Wexford Rd, Palmyra, PA  17078
large extra large
                   
Accommodations Available:
Comfort Inn Rivertfront
Off I-83 at Exit 23
525 S. Front Street
Harrisburg, PA  17111
1-800-comfort or   (Rate $89.00 per night)
(mention race when calling)
                 

Please mail the portion above this line

                  

 

 Sponsor Sheet  
Sponsor Address Amount
     
     
     
     

Total:

  

Participants Name:                                              

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