2nd Annual
SYNERGIZELIFE!
5K & 10K Run/Walk

Saturday, June 7th, 2008

All Net Proceeds To Benefit
The American Cancer Society

Last Name     First Name     E-mail Address    

Select Your Race     Select Your T-Shirt Size     Participant's Name and Estimated Time:    

$25 ENTRY FEE IS NON-REFUNDABLE


I accept responsibility for the accuracy of the provided information, and I understand that if this information is illegible or incomplete, it will affect the results and event scoring. In consideration of your acceptance of my entry, I, intending to be legally bound for myself, and anyone entitled to act on my behalf including dependants, spouses, and any representatives do hereby release and discharge SynergizeLife, its owners, agents, contractors, volunteers and representatives, The USATF, The County of Snohomish, The City of MillCreek, and any and all sponsors, contributors from any liability arising from illness, injury, damages, death or any acts of God, that I may suffer as a result of my participation in the 2nd Annual SynergizeLife 5K and 10K Run. I further grant permission to all of the foregoing to use any photographs, motion pictures, recordings or any other record of this event for any legitimate purpose. I have read the entry information provided and certify my compliance by my signature below. If participant is under the age of 18, I certify by my signature that the child has permission to participate, and is in good physical condition and that officials may authorize emergency medical treatment in the event of injury or illness.

By clicking the SUBMIT REGISTRATION button below, I acknowledge that I have agreed to the terms listed above.