T-shirt size:     S___ M__   L__   XL__    

I, have signed this entry form intending to be legally bound, hereby for myself, my heirs, executors, and administrators and release any and all rights and claims for damages I might have against the River to River Runner’s Club and the Race Committee, and officials and other sponsors of this event and their representatives for any and all injuries suffered by me in the event. I attest that I am physically fit and have sufficiently trained for the event and a licensed medical doctor has verified my physical condition. Furthermore, I hereby grant full permission to any and all of the foregoing to use my photograph or any other record of this event for any legitimate purpose. This entry is invalid unless signed by the entrant. If entrant is under 18 years of age then entry must be signed by parent/guardian. The official race director reserves the right to reject any entry.

Signature:__________________________Date: ___________Parent/ Guardian if under 18: ________________________________________________

Make check payable to River to River Runners      Mail to    Gene Tincher    2708 Childers Rd. Marion IL 62959(618) 694-9035 genetincher@gmail.com

Entry form's should be received by noon on Friday Feb. 6  to ensure a T-shirt. Make checks payable to RRR,  $20 . ($3 off for RRR members who preregister.)