Wildwoods Boardwalk 5K/1K Pumpkin Run/Walk

							         Wildwoods Boardwalk 10k/5K/1Mile Pumpkin Run/Walk
                              Saturday, October 30, 2010
                               Race Application – ALL Runners and Walkers
                                         MUST COMPLETE FORM


Last Name ______________________________________________________

First Name______________________________________________________

Address________________________________________________________

City________________________________ State________ Zip____________

Phone ____________ Email ________________________________________

Age ________ (as of Oct. 31 2010) Date of Birth                           ____________________

Entrance Fee: ALL PROCEEDS DONATED TO THE WILDWOOD’S K-8 SCHOOLS

10K Run:_____($25 Per Adult) ______ ($10.00 Per Child 18 & younger)

5K Run:_____($25 Per Adult) ______ ($10.00 Per Child 18 & younger)

5K Stroller Run _____($25 Per Adult)

5K Beginner Fun Run:_____($25 Per Adult) ______ ($10.00 Per Child 18 & younger)

1K Pumpkin Walk:_____($25 Per Adult) ______ ($10.00 Per Child 18 & younger)

T-Shirt size: (circle one) Small -- Medium -- Large -- X Large-- XX Large

Please read carefully before signing:                            In consideration of the acceptance of my entry in the 5K/1K
Boardwalk Pumpkin Run/Walk I, my heirs, executors and administrators hereby discharge Cape May County, the City of North
Wildwood, Wildwood, the Lunch with Lynch Foundation, the CMC FOP #7, the Wildwoods Convention Center and all the sponsors
and producers of this event, their agents, officers, employees, volunteers, event directors and event holders and anyone
associated in any way with the event, from all liabilities, actions, claims, demands, damages, costs and expenses which I may
now or in the future have against them arising out of my participation in the above mentioned 10k/5K/1K Pumpkin Run/Walk,
including but not limited to all injuries that may be suffered by me. I attest and verify that to the best of my knowledge, my
physical condition and fitness are adequate for me to safely compete in the race(s) mentioned above and that no physicians or
other individual has advised me against competing in any part of these events.
I certify that I have read this document and attest to its contents.

Signature ___________________________________________date__________
(Signature of parent if under 18)
Make Checks Payable To: Lunch With Lynch
Mail To: Lunch with Lynch, P.O. Box 1322, Wildwood, NJ 08260

                          Do not mail in registrations after Saturday - 10/22/10
                          There will be race day registration starting at 8:30 am
                               For more information visit www.LunchwithLynch.com