Churubusco Turtle Days Association

"PAST, PRESENT & FUTURE" 2008

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Please highlight and print selection for entry form 

 NAME___________________________________________________

 

 

ADDRESS________________________________________________

 

 

CITY__________________________STATE_______ZIP____________

 

SHIRT SIZE   S  M   L   XL

 

In consideration on acceptance of this entry, I waive for myself, my heirs, and assigns, any and all claims of damage against the Turtle Days Race Committee and their representaties, for any/all injuries received before, during, and after this event. I attest and verify that I am sufficiently conditioned to participate in this event.

 

SIGNATURE _________________________________DATE________

                   (Parent or guardian signature required if uner 18)