Turkey Hill Country Classic

15th Annual Country Classic

May 3, 2014

Youth Run Registration Form

Please print, complete, and mail this registration to:
Turkey Hill Country Classic
2601 River Road
Conestoga, PA 17516


Child's Name:   _____________________________

Address:  _________________________________
                _________________________________
                _________________________________

Phone:     _________________________________

Email:      _________________________________

Gender: Male   Female

Child's age ___________

Parent/Guardian:

Name:     _________________________________

Phone:     _________________________________

Waiver and Release: Please read prior to signing entry form.
I hereby request permission to participate in the Turkey Hill Country Classic Baby Derby. In consideration of the entry being accepted, I, intending to be legally bound for myself, my heirs, executors, administrators, waive and release any and all rights I have against the organization holding this event, its agents, representatives, sponsors, successors and assigns for any and all injuries suffered by me or damages out of, or related to, the event. I grant permission to use photos of me and release my name for any and all event purposes. All of the forgoing has been read by the undersigned and voluntarily been signed.

Signature:  __________________________     Date: ____________
(Parent/Guardian must sign)