16TH ANNUAL KINGS GRANT
WOODY PINKERTON MEMORIAL
5K RUN/WALK APPLICATION
Name ______________________________________________________
Street Address _______________________________________________
City _____________________________ State _______
Zip Code __________
Age on Race Day ________ Sex _________
Telephone ____________________________
Kings Grant Resident ___
T-Shirt Size: Small __ Medium __ Large __ XLarge __ XXLarge
__
Release: In consideration of the acceptance of my entry, I for myself,
my executors, administrators, and assignees do hereby release and discharge
Kings Grant Civic Association, The Athletes Foot, and other sponsors, organizers
and successors from all claims, damages, actions, and causes of action
whatsoever, in any manner arising or growing out of my participation in
said road race. I attest that I have full knowledge of the risk involved
in this event and I am physically fit and sufficiently trained to participate
in this event.
Signature : (parent or guardian if under 18 ) _________________________________________________________
Mail Entries to : Kings Grant Open Space Association - 50 Landings
Drive, Marlton, NJ 08053
Make Checks Payable to : Kings Grant Open Space Association