1. 5K Run for Disabled Sports USA
ATHLETIC TRAINING
5K Run for Disabled Sports USA
Date: Sunday, October 12th, Location: Student Center Patio Time: 9 AM with registration beginning at 8AM Price: $12.00 for Rowan Students- Staff $15.00 for Non-Rowan Participants. Checks/Donations made out to the Chuck Whedon Scholarship Cash is also accepted. For more information please contact Alejandro Arenas at (609) or at
********* Please Return this Form with Payment ********
Name: __________________________________________
Address: ___________________________________
Student/Non-Student: ____________________________
Cash/Check:_________ Total Amount: ______________
Date of Birthday: __________ Age: ____ Gender: M__ F__
**First 50 participants registered receive free T-Shirt!**
Adult shirt size (circle one): XS S M L XL XXL
Child shirt size (circle one): S M L XL
Waiver
I understand participating in this race is potentially hazardous. I understand the risks associated with participation in this event such as falls, contact with other participatns, and effects of weather. Having read this waiver I understand the accepting of my entry into the Rowan Athletic Training 5k Run/Walk event. I grant permission to all of the foregoing to use any photographs, videos, and any other record of this event for any legitimate purpose.
Signature: _____________________ Date: ________
(Parent/Guardian if under 18 years of age)