Fun Run c/o Peach Festival Races

70350 Henry Ross Drive

Romeo, MI 48065

 Make checks payable to; Peach Festival Races.

 

Name;____________________________________

 

Address;__________________________________

 

City;_____________________________________

 

State;________ Zip;_________________________

 

Phone;______________________ Age;__________

 

(  ) 5K  (  ) Fun Walk

 

In consideration of the acceptance of my application for the 2004 Peach Festival Run/Walk, I hereby release the Romeo Peach Festival, 
The Romeo Lions Club, Romeo Community Schools, The Macomb Daily
and The Advisor & Source Newspapers and All Volunteers, Agents,  Employees, Successors & Heirs, who are officially connected with this event from any claims, actions, losses, damages, expenses or bodily injury incurred by me or arising out of or in any way in conjunction with my participation in the aforementioned competition. I further state that I am in proper physical condition to compete in this event.                                           
                                                                                                     
                                                                                                     
                                                                                                    
                                 ______________________________________                              
     Your Signature, or  Guardians if under 18