July 4^th

Third Annual Old Jo’s 5K Firecracker Fun Run

Featuring a new course!

Sunday, July 4^th at 8:00 a.m. On The Square in Saint Jo, Texas

[23 miles West of Gainesville on U.S. Hwy 82]

[65 miles East of Wichita Falls on U.S. Hwy 82]

Entry Form

______________________________________________________________________________

Name                                                                                                               Age as of July 4, 2010

Street Address__________________________________________________________________

______________________________________________________________________________

City                                                                  State                               Zip

Circle your t-shirt size:       S       M       L      XL

Fee $15.00. Make Check payable to Saint Jo Chamber of Commerce. If mailed must be received by July 1^st.  You may register and pay your fee on race day at 7:00 a.m. On The Square.

Mail this entry form and fee to: Saint Jo Chamber of Commerce

                                                                                                c/o Arche’

228 Wagner Rd

Saint Jo, TX 76265

WAIVER OF CLAIM (MUST BE SIGNED): In consideration of acceptance of this entry, I, the undersigned, assume full and complete responsibility for any injury or accident which may occur during my participation in Old Jo’s 5K Firecracker Fun Run or while I am on the premises of this event, and I hereby release and hold harmless the sponsors, promoters, and all other persons and entities associated with this event from any and all injury or damage, whether it be caused by negligence of the sponsors or promoters or other persons or entities associated with this event.  Further, I grant full permission to use my photographs, videotapes, or recordings of this event for any legitimate purpose.

__________________________________________                                                              ____________________________

Signature of Runner (Signature of parent if under 18)                                                   Date

See you on the square in Saint Jo!  Get your 4^th off to a running start!