32nd Annual White River 4-Mile Classic Entry/Registration Form

7:30 am, 7 August 2010

Last Name___________________________First Name___________________________

Date of Birth______________________Sex M_____F______ Age on Race day_______

Address_______________________________________________________________

City______________________________State________________Zip______________

Shirt Size: Circle One: Youth Medium- Youth Large- Adult Small- Adult Medium- Adult Large-
Adult X-Large- Adult XX Large-
Womens Cut-____________

Note: If you do not check "Womens Cut", you will get a regular uni-sex t-shirt.

You may walk, but there is only a runners category for awards.

ENTRY FEE: If you are a student, please check here______
Pre-registration (mailed-in by 26 July 2010); Adults: $10.00, Students (18 and under): $5.00
Day of Race registration (6:00 -7:00 a.m.): Adults: $15.00 , Students (18 and under): $10.00

Make checks payable to: White River Roadrunners Club, 169 W. Ross St., Batesville, AR 72501

RACE RELEASE (Must be signed by participant/parent or guardian)
I understand that my consent to these provisions is given in consideration of the acceptance of this registration and for being permitted to participate in this event. I am a voluntary participant in this event, and in good physical condition. I know that this is a potentially hazardous activity and I hereby assume full responsibility for any injury or accident which may occur during my participation in this event or while on the premises of this event. In consideration of acceptance of this entry, I waive and release any and all claims for myself and my heirs against the race organizers, the White River Water Carnival, and any and all sponsors of this race from any liability or any loss, damage, or injury which I may incur as a result of my participation in this race. I further state that I have trained and I am in proper physical condition to participate in this race. This entry is not valid unless signed by entrant. If entrant is under 18 years of age, parent or guardian must sign entry form.

Signature__________________________________________Date__________________
Parent/Guardian Signature_________________________________Date______________

Entry form not valid without signature and will be returned. Parents must sign for children under 18. Must have one form per person with signature. Photocopies are acceptable.
IPICO CHIP Instructions
1. All timed participants must pick up a timing chip race morning.
2. Timing chips must be affixed to your shoelace with a zip tie provided race morning.
3. Please do not swap timing chips with family or friends.
4. Results will be calculated by Chip Time.
5. Return your timing chip to a volunteer after you finish.
6. Please do not exit the finish chute with your race-day timing chip.
7. Participants will be charged $30 for timing chips not returned after the race.
8. Further instructions for timing chips will be announced on race day.