4th Annual Saint Mauro’s
Festival 5k Run
“Run for the Cannoli”
Sunday, August 19,
Our Lady of Grace Church
COURSE: Through the northwest section of the streets of
DATE:
TIME:
PLACE: Our
Lady of Grace Church, 13th and Vine Streets,
ENTRY FEE:
$15.00 ….. Make checks payable to: Our Lady of Grace Church
Please mail entry to Dino Oberto,
ATTENTION to: “Festival
5K”
Deadline for Pre-Entry is
AMENITIES:
T-shirt for all registrants. Small, Med, Large, XL
$5.00 in St. Mauro Festival food tickets to all entrants.
AWARDS: Overall
male/female winners receive trophy.
MALE/FEMALE 1st, 2nd &
15 & under, 16-19, 20-24, 25-29, 30-34, 35-39,
40-45, 46-50, 51-55, 56 -60, 61 & over
RACE REGISTRATION: Will be held from
Grace Church, 13th & Vine Streets,
CONTACT: Race
Director, Dino Oberto, 570-401-8168 [email protected]
2007 Entry
Form (Please print or type)
NAME: _________________________________________
PHONE: ______________
ADDRESS:______________________________________________________________
CITY:
T-SHIRT SIZE:
S
M
L
XL
WAIVER APPROVAL (All Entrants Must Sign)
I know that participating in a road race is
potentially hazardous activity. I should not enter and participate unless I am
medically capable. I agree to participate according to my ability to safely complete the course. I assume all risks associated
with running in this event including, but not limited to falls, contact with
other participants, the events of the weather, including high heat or humidity,
traffic conditions of the road, all such risks being known
and appreciated by me. Having read this waiver and knowing
these faces in consideration of your accepting my entry, I, for myself and
anyone entitled to act on my behalf, waive and release Our Lady of Grace Church
and the city of Hazleton, Borough of West Hazleton, Hazle
Township and all sponsors, their representatives, and successors, race
volunteers, race directors, from all claims or liabilities of any kind arising
out of my participation in this event.
SIGNATURE of ENTRANT: _______________________________
DATE: _________
SIGNATURE of PARENT IF UNDER 18:
________________________________