CdLS Awareness 5K Run/Walk 
February 9, 2008, 10:00 a.m.
Decatur, GA - Medlock Park

OFFICIAL ENTRY FORM – PLEASE PRINT

First Name: _________________________________ Last Name_____________________________________

Street Address: ___________________________________________________________________________  

City, State, Zip: ___________________________________________________________________________

Daytime Phone: ____________________  Email: __________________________     Age: ______    Sex: ______

T-shirt size (circle one):     S        M        L        XL                Fee Enclosed: $_______ 

____ Phantom Runner: I am unable to participate, but I would like to support CdLS with my enclosed tax-deductible contribution.

Cost: Long-sleeved T-shirts guaranteed to pre-registered runners on race day.
5K: $18 by 2/02/08. Late and race day registration will be $23.

Waiver: In consideration of the acceptance of this entry to the CdLS Awareness Run/Walk, I waive any and all claims for myself and my heirs and assigns on the officials and sponsors of the race any injury or illness which may result from participation. I realize this is a physical event which requires proper physical health. In the event of severe weather conditions, the race will be cancelled and your entry fee will be considered a donation.

Signature of Participant ________________________________________________ Date _______

Signature of Parent/Guardian ____________________________________________ Date ________
(if participant is under 18)

Please make all checks payable to
CdLS Foundation

Please return completed registration form to:
Jen Pomfret
2679 Jodeco Drive
Jonesboro, GA 30236