High Rock Hop Entry Form

Official Entry Form:

Disclaimer: By entering the event, I promise that (1) I am not a candy-ass whiner; (2) if I get injured in anyway by participating in this run, I acknowledge that it's my own dern fault, and I'm not going to blame or sue anyone else for it; and (3) if I do try to sue anybody, I will pay all their legal expenses plus contribute $1 million to Sam's retirement fund.

Sign Here:________________________________________________________

Name:____________________________________________________________

Address:________________________________________________________________________________

Email address:___________________________________________________________________________

Age: ________________________________ Bib #:______________________________

CIRCLE ONE: ________5-Mile Trail____________ 10-Mile Trail__________

Registration for the 5.5mile and 10 Mile race remains FREE. T shirts can be purchased for $15.

Send this form to Sam Cooke:
Fax: 870-793-7745
Email: sdcooke22@hotmail.com
Mail: 22 Southridge Ct., Batesville, AR. 72501