Walk or Run for the Arts - Salem Art Fair 5k 2008

Walk or Run for the Arts - Salem Art Fair 5k
OFFICIAL ENTRY FORM - Only ONE entrant per form    (Please Print Clearly)

PLEASE CHECK:    |_| 5K Run    |_| 5K Walk

Individual Entry Fees 5K Walk or Run (no T-shirt) $10
       T-Shirt: ADD $10 - Shirt Size: Adult |_|S |_|M |_|L |_|XL
       LATE FEE (after 7/17): ADD $4
       TOTAL AMOUNT ENCLOSED: $___________

First Name _________________ Last Name _________________

Age (on 7/19/08) _____ Sex |_| M   |_|F

Street Address __________________________________________

City, State, Zip ________________________________________

Day Phone # (_____)______________

e-mail: ______________________ e-mail results: |_| Yes|_| No

RELEASE
I personally assume all risks incident to my participation in the Walk or Run for the Arts - Salem Art Fair 5k including, but not limited to, use of facilities, the use of the streets, and all hazards from running or walking in this event. I hereby release for myself, my heirs, executors and administrators, all sponsors of this race including, The Salem Art Association, Gallagher Fitness Resources, Brooks, City of Salem, Spiridon Race Management, and any other sponsors not mentioned from any and all claims, demands, action, or causes of action incident to my participation in this event. I also understand that the entry fee is non-refundable and that race mementos are guaranteed only to those who pre-register and pick up their materials prior to the event. I grant permission to all the foregoing to use any photographs, motion pictures, video, or any other record of this event for any legitimate purpose. As required by insurance, all wheeled devices are prohibited from participating in this event (includes strollers, baby joggers, skates, skateboards, bicycles, etc.)

Signed ___________________________________ Date__________

Parent or guardian _________________________ (if entrant under 18)

Payment must accompany application payable to:
Salem Art Association
600 Mission St. SE
Salem, Oregon 97302
MUST BE RECEIVED BY THURSDAY, 7/17/08