Candler Park Fall Fest 5K 
October 13, 2007
Atlanta, GA

OFFICIAL ENTRY FORM – PLEASE PRINT

Please Print All Requested Information:

First Name___________________________________ Last Name____________________________________

Address_____________________________________________________________________ 

City__________________________________        State __________         ZIP __________ 

Telephone_________________________   E-mail_________________________

Circle One:

  Age ____________   Sex ____________          Adult t-shirt size:      S        M          L         XL        

Cost: $18 by 10/09. After 10/09 and Race day registration will be $23. 

Waiver (Entry not valid unless signed.) “In consideration of acceptance of this entry, I, the undersigned do waive and release any and all claims, causes of action and any liability whatsoever, for myself and my heirs, against the Candler Park Pool Association, The Candler Park neighborhood organization, Candler Park Running Club ,Road Race Services, any sponsors and all officials of this race for any injury, illness or other damages of any kind which may arise out of or result from my participation in the 2007 Candler Bark K9 Fun Run. I know that running a road race with my dog is a potentially hazardous activity. I further state that my dog and I are in proper physical condition to participate in this event. Warning: I understand that high heat and humidity can be extremely dangerous. I will not overexert myself or my dog(s) under these conditions.

Signature ______________________________________________

Parent/Guardian if under 18 _________________________________

Make your check payable to Candler Park Neighborhood Organization (CPNO)
Mail form to:  
Candler Park Running Club
1445 Benning Pl
Atlanta Ga. 30307