Monster Mash Dash - October 4, 2008
Web Entry Form
r 5 Mile Run   r  5K non-competitive walk
Name:___________________________________  Age on 10-4-08:______r Male r Female
Street:_______________________________________________________________________
City:________________________________________State:_____________ Zip:___________
Day Phone:_________________________ Evening Phone:___________________________
E-mail address _____________________________________________________________

T-Shirt size: r S r M r L r  XL r XXL
Fees:
Pre-registered on or before October 3 - $18.00
Raceday fee - $20.00
CHECKS ARE PAYABLE TO: Tuxedo Brothers

Mail completed entry form and entry fee to: 
Tuxedo Brothers, 6265 Boone Ridge, Zionsville, IN 46077
RACE PARTICIPATION AGREEMENT: In consideration of the foregoing, I, for myself, my heirs, executors and administrators, waive and release any and all rights and claims for damages I may have against any of the sponsors, organizers, City of Indianapolis, Department of Parks and Recreation, Tuxedo Brothers, Inc., for any and all claims of damages, demands or loss actions whatsoever which may arise as a result of my participation in this event. I understand and acknowledge that participating in this run/walk event may expose me to dangers from both known and anticipated risks. I attest and verify that I am physically fit and have sufficiently trained for the completion of this event and my physical condition has been verified by a licensed medical doctor. Further, I grant full permission to any and all of the foregoing to use my likeness for any legitimate purpose whatsoever.

Signature_______________________________________________ Date __________________
Parent’s or Guardian’s Signature if under age 18______________________________ Date ______________
Incomplete/unsigned entries will not be accepted. - Entry form can be copied.