7th Dreaded Druid Hills 10K Run
Saturday, June 30, 2007 - 7:30 AM Start
Moorish Tower at Druid Hill Park, Baltimore, MD

Make checks payable to: Dreaded Druid Hills 10k
Mail to: Falls Road Running, 6247 Falls Road, Baltimore, MD 21209
Do not mail after June 20 - Do not send cash
Type Information, Print, and Sign Entry Form

Event:    10K   
Entry Fees: $10 prior to June 20st -walk-up only afterwards- $15 on race day 
no confirmations or refunds
 Last Name:     
Address:  
City:       State:        Zip:   -
Age on race day:           Sex: M  F                                                                                              
Date of Birth:   / /

Race Premium - Asics Sport CoolMax Air-Flo Tee.  This costs an extra $15 over the race entry fee.

Please note that the shirt sizes are in both Male and Female sizes.  Females will receive a female sized shirt, so plan accordingly.             Male Shirt Size: M  LG  XL                                   Female Shirt Size:  S  M  L 
(Please note again that the shirt sizes are in men's and women's sizes)

Day Phone:   - -  Evening Phone: - -
 

Email:

I am enclosing my entry fee in the amount of:                                      $
I am enclosing a Premium fee of $15:                                                  $
   Total enclosed (absolutely no refunds):                                               $

Waiver/Release Must be Signed Before Mailing:

In consideration of my application being accepted, I hereby for myself, my heirs, personal representatives and executors, waive, release and forever discharge any and all claims for loss or damages which I may have or may hereafter accrue to me against the organizers and sponsors of the Dreaded Druid Hills 10K Run, including without limitation any sponsors, patrons or supporters and their respective representatives, successors, and assigns, for any and all injuries which might be suffered by me in said event. I attest and verify that I am physically fit and have sufficiently trained for the completion of this race. Further, I hereby grant full permission to any and all of the foregoing to use my name, photographs, videotapes, motion pictures, recordings or any other record of this event for any legitimate purpose, without compensation or remuneration.

_________________________________________________________     __________
Signature (parent or guardian if under 18)                                                              Date