IKEA-Montour Trail 12th Annual
Half Marathon & 5K Run, and Fun Walk
Saturday September 8, 2007

Benefit of the Montour Trail
ENTRY FEES
  Adults
Half Marathon Entry Fee
Pre-Registration (Postmarked by September 2) $28
Race Day or Packet Pickup $35
5K Run Entry Fee
Pre-Registration (Postmarked by September 2) $22
Race Day or Packet Pickup $30
5K Fun Walk Entry Fee
Pre-Registration (Postmarked by September 2) $15
Race Day or Packet Pickup $20

Make checks payable to:
IKEA-Montour Trail 1/2 Marathon
(Please do not sent cash.)


Mail to:
IKEA-Montour Trail 1/2 Marathon
PO Box 459
Imperial, PA 15126
Please print
Name:
Address:
 
City:                                State:      Zip:
Phone:
Email:
Age:           Date of Birth: 
Championchip Number(if own):
Sex:   M      F
Event: Half Marathon   5K Run   5K Walk
T-Shirt Size:
 S     M     L     XL  XXL 
Waiver: : In consideration of the acceptance of this entry, I waive for myself, my heirs, and assigns, all rights and claims for damages which I might have against the IKEA-Montour Trail ½ Marathon and 5K Run and Walk to be held Saturday, September 8, 2007, IKEA USA, The Montour Trail Council, other sponsoring organizations, businesses, or individuals as a result of any and all injuries suffered by me in that event. I attest and verify that I am an amateur and physically fit and have trained sufficiently for this event. I also release any photos that may involve myself. Also, by signing this waiver, I become responsible to the race and to Runner’s High for the rental ChampionChip issued to me. If I do not return this chip to the race committee on race day, I hereby agree to pay the event a replacement fee of $30.
Signature:
If under 18, parent or guardian must sign below:
                                                                         
Signature of parent or guardian