Rodeo Run Entry Form

You may print this form, complete it, and mail it to enter.

Mail Entry To:
Megan and Aaron Peer
Attn: New Windsor Rodeo Run
3912 10th Avenue
Moline, IL. 61265 		MAKE CHECK PAYABLE TO:
New Windsor Rodeo

ENTRY FEE:
Pre-Registration Race Fee
On or Before August 12:  $15.00
(Guarantees T-Shirt to first 200 entries)
After August 12:  $20.00

NAME   _____________________________________________
ADDRESS   _________________________________________
CITY  ______________________________________________
STATE ______________  ZIP CODE _____________________
PHONE _________________  AGE ________  SEX   M  F  (CIRCLE)
E-Mail ______________________________________________

T-SHIRT SIZE: (CIRCLE) M  L  XL           RACE: (CIRCLE)    2-MILE   4-MILE

   In consideration of my entry.  I, intending to be legally bound, for myself, my heirs, executors, and administrators, waive, release, and forever discharge any and all rights and claims which may hereafter accrue to me against the officials of the Run, the New Windsor Ball Association, the village of New Windsor, and the County of Mercer for any and all accidents or injuries incurred by me at this event.  I further state that I have trained adequately and am in suitable condition to compete in this race.

Signature _________________________   Date ___________________

(Parent or Guardian, If under 18)