St. Patrick's Day Road Race Entry Form 2001

Schedule of Events: Race day registration and packet pick-up will take place at 7:30 am at the corner of Jordan Road and Mesquite.  The races will begin at 8:00am.  Everyone is then invited to stay for the 31^st Annual Sedona St. Patrick’s Day Parade “Erin Go Bragh”, which will take place on Jordan Road at 10am.

Race Course: See map on the back of this form.

Parking:  Designated parade parking areas.

Cost:  $10 for children under the age of 12 and $15 for adults.  (There will be a $3 late fee for entrees after March 3^rd)

Includes:  commemorative T-shirt (not guaranteed on-site for late registration participants), awards, refreshments, and finish results.

Questions:  Chuck Hammersley in Flagstaff at: (520) 523-6655

Please make checks payable to the Sedona Main Street Program.

Mail Check and Application to:               Sedona Main Street Program

                                                                        450 Jordan Road, PO Box 1363, Sedona, AZ 86339

____________________________________________________________________________

One Mile Run/Walk________ or 5K Run_________

Shirt Size:  Kids L ( )  Adult S ( ) M ( ) L ( ) XL ( )                Gender:          M ( )    F ( )

Name:_____________________________________________Age:___________

Address:_________________________________Phone:____________City:______________________

State:________Zip Code:___________

Waiver (please read and sign): In consideration of your acceptance of this entry, I hereby, for myself, my heirs, my executors, and administrators, hereby waive any and all rights and claims for damages I may have against the sponsors, coordinating groups, and any individuals associated with the event, their representatives, successors, and assigns, and will hold them harmless for any injuries suffered in connection with said event.  Also, none of the above are responsible for the loss of personal items nor any other form of aggravation in connection with said event.  I have been warned I must be in good health and prepared to participate in this physically demanding event.  In filling out this form, I acknowledge I have read and fully understand my own liability and do accept the restrictions.

Entrant’s Signature:_____________________________________________Date:___________

                                    (Parent/guardian’s signature required if entrant is under 18)

"In compliance with the Americans with Disabilities Act, this agency/event does not discriminate on the basis of an individual's disability.  If special accommodations are required to participate, please notify us during parade registration."

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Copyright 2001 Northern Arizona University, ALL RIGHTS RESERVED