
Saturday, April 30, 2011
9:00 am
Rain or Shine!
presented by

100 Borton's Mill Road (Croft Farm)
Challenge Grove Park, Cherry Hill, NJ
Race Benefits:

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Contact: Megan Brown
MBrown@chtownship.com
The route runs through Challenge Grove Park
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First Name ___________________________ Last Name _______________________
Age ______ Sex ______
Address ________________________________
City ______________________________ State _______ Zip Code __________
Phone _____________________ Email ________________________________
Please check one of the following:
T-Shirt size: S ___ M ___ L ____ XL ____
In consideration of accepting this entry, I, the undersigned, assume full responsibility for any injury which may occur during the event or while I am on the premises of the event. I hereby release and hold harmless Camden County, Cherry Hill Township and the Run Your Own Life 5K sponsors, promoters, race supervisory personnel and their representatives, and all other persons and entries associated with this event, whether injury or accident is caused by negligence on the par of the sponsors, promoters or other persons. I verify that I am physically fit and have sufficiently trained for this running event and my physical condition has been verified by a medical doctor. I acknowledge that the sponsors of this event have not had an opportunity to evaluate the condition of my health and are relying on my representation that I am physically able to enter and compete in this event. I hereby grant full permission to any and all of the foregoing to use any photographs, videotapes, recording and records of this event. The Race Director has the right to alter the course and/or the prize structure if the need arises.
THE UNDERSIGNED HAS READ AND VOLUNTARILY SIGNED THIS RELEASE
& WAIVER
X____________________________________ Date ________________
(Parent's signature if 18 and under)
Make checks payable to: Cherry Hill Township
Mail Checks to: Cherry Hill Township
820
Mercer Street
Cherry
Hill, NJ 08002