On your Mark for the Parks
Web Entry - September 4, 2006

First Name___________________________  Last  Name______________________________
Address______________________________________________________________________________
City______________________________    State____________     ZIP____________________________
Phone-day___________________________     Phone-evening_________________________
E-Mail Address _______________________________________________________
Sex rM  rF    Age_____  T-shirt:   Short sleeve   rS  rM  rL  rXL  rXXL
                                                                                                  
Check event:  r5 Mile Run         r5K Racewalk         r 5K Fitness Walk
Pre-registration fee for 5 Mile & Racewalk is $18
Pre-registration fee for 5K non-competitive walk is $16
ALL events on event day are $20 - (shirt size and availability may be limited)

Make Check payable to:  Tuxedo Brothers
Send entry to:  Tuxedo Brothers
                       6265 Boone Ridge
                       Zionsville, IN 46077

Waiver (must be signed)
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 Carmel, Carmel Clay Parks and Recreation, St. Vincent Hospitals, Tuxedo Brothers, Inc., for any and all claims of damages, demands or less actions whatsoever which may arise as a result of my participation in this event.  I understand and acknowledge that participating in this walk/run 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. I understand that I will be using a Champion Chip timing device and must return it upon completion of the event or pay $30 to the organizer.  Further, I grant full permission to any and all of the foregoing to use my likeness for any legitimate purpose whatsoever.

______________________________________________________        _______________
Signature of Entrant                                                                                         Date
(Signature of parent/guardian if entrant is under 18 years old.)
*Advance registrations must be post marked by August 30.