Maple Heights High Athletics/Cross Country Presents: THE MAPLE HEIGHTS HIGH ATHLETICS/ CROSS COUNTRY 5K FUND-RAISER Sunday, July 17, 2011 Course information: Course begins and ends at Stafford Stadium, 5403 Mayville Road Maple Hts, OH 44137 Schedule: 7:45 AM registration Race starts at 9:00 AM Entry Fee: $15 Pre-registration, Pre-Registration is strongly encouraged! $20 Day of the Race (July 13 Pre-registration deadline) Online at HMAPromotions.net or 216-752-5151 Mail to: ATTENTION TOM O’CONNOR Maple Heights High Athletics/Cross Country Fund-Raiser, 5500 Clement Drive, Maple Hts., OH 44137 (Checks payable to Maple Heights High Athletics/ Cross Country Fund-Raiser) Features: T-shirt to first 200 resistered * Water stops* Refreshments following the run * Parking available at Stafford Park * Awards to Top 3 Overall Men and women. 14-under, 15-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70 and over. XC and Maple Heights Alumni * ** PROCEEDS BENEFIT THE MAPLE HEIGHTS HIGH ATHLETICS /CROSS COUNTRY FUND** Name:_______________________________________ E-mail: _______________________________________________ Address:_____________________________________ City:___________________ State:_______________ Zip:_______ Phone:____________________________ Gender:_____ Age:______ D.O.B:___________ Maple Alumni: Yes or No T-shirt Size (Circle one): S M L XL $______Additional Donation to Maple Hts. High Athletics/ Cross Country Fund In consideration of the acceptance of the entry to the Maple XC 5K Run, I do hereby, for myself, my Heirs, executors and administrators waive, release and discharge the Maple Hts.High Athletics/Cross Country Foundation, HMA Productions and any additional host and sponsors, or their respective agents, representatives and employees from all claims, demands and rights of cause or action, present and future whether known of anticipated resulting from or arising out of either directly, my participation. I attest that I am physically fit and sufficiently trained for the completion of this race. I have read and understand the foregoing assumption of risk and release. Signature X_________________________________________ Date: _________________