XX Annual 5K10k FOG RUN

1
The Victim/Witness Auxiliary Board and the Kern
County Probation Department
XX Annual 5K-10k FOG RUN
XX Annual 5K-10k FOG RUN
Commitment to a Safe Community
Proceeds to Benefit Victims Of Crime in Kern
County
January 10TH, 2009 Lake Ming 900am
Life-Run For It
Long sleeve wicking running shirt, guaranteed
to all pre-registered entries! Custom race
medals up to 3rd place in all age groups! Huge
Raffle and Free Massages! Hot Pancake and
Sausage Breakfast Pete Wonderly With Great
Music and Announcing!
RACE DAY REGISTRATION TIME IS 700 AM to
830AM. Race Starts 900 AM PRE-REGISTRATION
22.00 (adult), 17yrs. and under 17.00 before
Dec. 3rd, 2008 Special Family Pre-Registration
Discount 15.00 per child with each paying
adult RACE DAY REGISTRATION 25.00 (adult),
20.00 (17-under) Contact Mic Hall for School
Team Rates and Course info Contact Lupe Perez at
661-868-4507 or Mic Hall at 661-324-0311 Please
make all checks payable to V.W.A.
P.O. Box 3309 Bakersfield, Calif. 93385
----------------------------------------
--------------------------------------------------
--------------------------------------------------
--------------------------------------------------
-- ______________________________________________
__________________________________________________
_________________ LAST NAME
FIRST
NAME
TELEPHONE _____________________________
__________________________________________________
__________________________________ STREET ADDRESS

CITY
ZIP T-SHIRT SIZE
SM____________ MED_____________LG_____________X
LG_____________XXL____________ CHECK ONE
5K RUN_____________10K RUN____________
MALE________ FEMALE_______ AGE GROUP 12
UNDER________13 15_______16 -19________ 20 -29
________30 -39 _________ 40 49 ________ 50
59 _________ 60 69 _________ 70 OVER
__________ WAIVER I the undersigned , for
myself, my agents, heirs, executors, personal
administrators, and representatives, do hereby
release and waive any and all claims for damage
caused by a act or omission of Releases, but not
limited to, Kern County Probation Department,
Victim-Witness auxiliary of Kern County, and
their sponsors, advertisers, advisors,
principles, agents, representatives, and all
individuals associated with the event. I agree to
hold them harmless and indemnify them. I am fully
aware of the risks an dangers, and hazards,
including death, and do voluntarily agree to
assume all risks connected with this event, that
might be sustained by me, including, but not
limited to personal injury, death, property /
damage. I am in good health and I am capable of
participating in this event. Participant
Signature _____________________________________
___________________________________ Parent /
Guardian Signature (17 under)
__________________________________________________
________ Date ___________________________ E-mail
______________________________________