Around Peachtree Battle 5K         
January 30, 2010
Atlanta, GA

OFFICIAL ENTRY FORM – PLEASE PRINT

Please Print All Requested Information:

Last Name_______________________________First Name_______________________Middle Initial______   

Address___________________________________________ Telephone___________________

City___________________________________  State______ Zip Code___________

Shirt size:  (circle)    S    M     L     XL    

Cost: $25
Waiver: I know that running a road race is a potentially hazardous activity. I should not enter and run unless I am medically able and properly trained to complete the course in less than 1.5 hours. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I understand that the course will be closed once runners doing a 1.5 hour pace have passed. I assume all risks associated with running in the 2010 Around Peachtree Battle 5K including but not limited to falls, contact with other participants, the effects of weather, including high heat and/or humidity, traffic and the conditions of the road, all such risks being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of your accepting my entry, I, for myself and anyone on who's half I am entitled to act, waive and release JT and Vanessa King, Atlanta Union Mission, all city, county and state governments, their representatives and successors from all claims or liablities of any kind arising out of my participating in this event. I understand that all entries are final with no refunds. The official race director reserves the right in any event of emergency or local or national disaster to cancel the race or to change the day and or time to a later day and that in that event of cancellation or change there is no guaranteed refund of entry fees.

Signature ______________________________________________

Parent/Guardian if under 18 _________________________________

Make Check Payable to Atlanta Union Mission

Mail registration form to:
Around Peachtree Battle 5K
531 Westover Drive
Atlanta, GA 30305