
Saturday, May 22, 2010
9:00 am
Rain or Shine!
Saddler's Woods Volunteer Area
250 MacArthur Blvd
Haddon Township, NJ 08108
Race Benefits:
Saddler's Woods Conservation Association
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Contact Chuck Sellers 609-509-0987
cisellers@verizon.net
Down MacArthur Blvd to Cuthbert Blvd to Newton Lake Park around park and back
The Pour House
Pinelands Nursery
Cork
Westmont Fire Co. #1
Haddon Township Police Dept.
Haddonfield Running Company
Westmont Ace Hardware
Super Fitness
Blue
DQEvents
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First Name ___________________________ Last Name _______________________
Age ______ Sex ______
Address ________________________________
City ______________________________ State _______ Zip Code __________
Phone _____________________ Email ________________________________
Please check one of the following:
___ 5K ___ 1 Mile
___ Haddon Township Resident ___ SWCA Member
T-Shirt size: S ___ M ___ L ____ XL ____
IN CONSIDERATION FOR ACCEPTING THIS ENTRY, AND THE GRANTING OF THE RIGHT TO PARTICIPATE IN THIS EVENT, I, THE UNDERSIGNED, INTENDING TO BE LEGALLY BOUND, HEREBY FOR MYSELF, MY HEIRS, PERSONAL REPRESENTATIVES, SUCCESSORS, AND ASSIGNS, WAIVE AND RELEASE ANY AND ALL CLAIMS FOR LOSSES AND DAMAGES I MAY HAVE AGAINST,THE POUR HOUSE, COMMISSIONERS OF HADDON TWP., HADDON TWP., WESTMONT, THE POLICE DEPT. OF HADDON TWP., EVENT COMMITTEE, VOLUNTEERS, DQ EVENTS, THEIR REPRESENTATIVES, SUCCESSORS, AND ASSIGNS AND/OR ANY OTHER PERSON WHOMSOEVER FOR ANY AND ALL INJURIES, ILLNESS, INCLUDING DEATH, THAT MAY RESULT FROM MY PARTICIPATION IN SAID EVENT. I REPRESENT AND AFFIRM THAT I AM IN PROPER PHYSICAL CONDITION TO PARTICIPATE IN THIS EVENT, AND VERIFIED BY A LICENSED PHYSICIAN, AND HAVE SUFFICIENTLY TRAINED FOR THE COMPLETION OF THIS EVENT.
THE UNDERSIGNED HAS READ AND VOLUNTARILY SIGNED THIS RELEASE
& WAIVER
X____________________________________ Date ________________
Make checks payable to: Saddler's Woods Conservation Association
Mail Checks to:
Saddler's
Woods Conservation Association
PO
Box 189
Oaklyn,
NJ 08107