Cambridge EMS Cannon Ball Run - Registration Form
Make checks payable to:	Cambridge EMS Cannon Ball
Print this form, fill it out and send to:	Cambridge EMS PO Box 272 Cambridge, WI 53523 Fax: 608-423-3211

Name Address City, State, Zip Day Phone Evening Phone Email Address Age on 7/12/2008 Sex   Select Event    ___  10K Run - 8:30 a.m.    ___  5K Run - 8:30 a.m.    ___  1 mile Trophy Dash - 8:30 a.m. Select Age Division    MEN    ___  Under 18    ___  18-29    ___  30-39    ___  40-49    ___  50-59    ___  60+    WOMEN    ___  Under 18    ___  18-29    ___  30-39    ___  40-49    ___  50+   Circle Shirt Size    Cannon Ball Shirt:    Small      Medium      Large      X Large      XX Large      In consideration of my signing this agreement, I hereby for myself, my heirs, executors and administrators, assume any and all risk might be associated with the Cannon Ball Run. I wave and release any and all rights and cliams for injuries or damages I may have against the race, its organizers, sponsors, race officals of this event, and assign for any and all claims of the injuries, damages of any kind, demands and actions whatsoever in any manner suffered by me as a result of my participation in said run.   Participant's signature Date   Guardian's signature, if participant is under 18 Date

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