Red Devil Dash 5K
September 13, 2008
Atlanta, GA

OFFICIAL ENTRY FORM – PLEASE PRINT

Please Print All Requested Information:

Name: ______________________________________________ Age:______

Male____ Female____

Address: _______________________________________________________________ Telephone______________

City, State, Zip: ___________________________________________________________________________

Event: 5K Run_______ 5K Walk_______ Email: _____________________________________

Phantom Runner----Cannot run but making a donation & want t shirt—Amount enclosed------

T-shirt size (circle one): S - M - L - XL - XXL

Waiver: I know that running a road race is a potentially hazardous activity. I am in proper physical condition to compete in this run/walk and assume all risks associated with my participation, including but not limited to falls, contact with other participants, the effects of the weather including high heat and/or humidity, traffic, and the conditions of the road, all such risks being known and appreciated by me. I will not wear headsets or any device that restricts my hearing or other perception. Inconsideration of this entry, for myself and anyone entitled to act on my behalf, I waive and release all race officials, volunteers, sponsors, and any others associated with this event from legal liability. Furthermore, I hereby grant the agents of this event permission to use photographs, videotapes, motion pictures, recording or other record of use in this event for legitimate purposes.

Signed: _____________________________________ Date: __________________________

Make checks payable to Druid Hills Soccer Boosters and mail to:
Hicks 5K Race
272 Vickers Drive
Decatur, GA 30030

All proceeds benefit the Philip Hicks Memorial Soccer Scholarship Fun and the Druid Hills Soccer Booster Club.