Type Information, Print, and Sign Entry Form
Superbowl 5-K
Sunday February 3, 2008 - 10:00am
Community College of Baltimore County, Dundalk Campus

Make checks payable to: Baltimore County Police Memorial Fund, Inc.         
Mail to: Super Bowl 5-K, PO Box 5464, Towson, Maryland 21285
Do not mail after January 30 - register at store or the race after the 30th

  5K           1 Mile Walk/Run 
Entry Fees: $25 prior to February 3 - $30 on raceday 
 Last Name:     
Address:  
City:       State:        Zip:   -
Age on race day:           Sex: M  F                                                                                              
Date of Birth:   / /     
Home Phone:   - -     Long Sleeve T-shirt: S   M    L  XL

Law Enforcement Employee: No  Yes
Team Information: Male  Female  Coed
Team Information: Agency/School/Organization:
Team Captain    Team Name ______________________________________________________________

Waiver/Release Must be Signed Before Mailing:

In consideration of the acceptance of my entry, I, for myself, my executors, administrators, and assignees, do hereby release and discharge The Baltimore County Police Assistance Relief Fund, Baltimore County sponsors, volunteers, Charm City Run Events and Race Director of all claims of damages, demands, and any actions whatsoever in any manner arising from my participation in said athletic event. I attest that I have full knowledge of the risks involved in this event and I am physically fit and sufficiently trained to participate in this event.  

_________________________________________________________     __________
Signature (parent or guardian if under 18)                                                              Date