Name      Age  (as of 11/01/2008) 

 Sex  Male   Female     E-Mail 

       T-Shirt Requested

QTY	DESCRIPTION
	(Add $2 to fee for XXL and $1 additional dollar for each additional size)

In consideration of accepting this entry, I, the undersigned, intending to be legally bound hereby, for myself, my heirs, executors and administrators, waive and release any and all rights and claims for damages I have may have against the Fort Gordon Ordnance Corps Association, Fort Gordon, GA and any sponsors, as well as any person involved with this event. I fully understand that I, or the person I am responsible for, will be subjected to roads that may have uneven terrain, rocks, and other obstacles, but that I am physically fit and have sufficiently prepared for this race. My physical condition has been verified by a licensed medical doctor. I hereby grant full permission to the Fort Gordon Ordnance Corps Association to use any photos, videos, or any other record of this event for any purpose.

 

Signature  _______________________________________     -- mm/dd/yy

Parent's Signature __________________________________  (If Under 18)

After completing this form please print and fax a copy to (706) 791-6598