6th Annual Parker River National Wildlife Refuge

Race Against Extinction

10K Road Race & 4 Mile Walk

Organized by the Winner's Circle Running Club & Friends of Parker River National Wildlife Refuge

First Name: [ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ]

Last Name: [ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ]

AGE: [ ][ ] SEX: [ ]

Street Address ______________________________________________   

Town:_________________________  State:________   ZIP:__________

Telephone #:_________________________ 

Check: 10K___  WALK___                    Enclosed: $10 w shirt ____    
                                                    $6 no shirt ____ 
                      I would also like to 
                      purchase a Commemorative Sweatshirt @ $20 ____
                     (sweatshirts must be ordered by May 28)
                                            Total Enclosed $________   

In signing this entry, I for myself, my executors, and administrators, release the manager of the race, the Federal Parks Department, and all sponsors and promoters from any and all liability and damages in case of death or injury received in or any way associated with this race.

SIGNATURE: (guardian if under 18) ______________________________ DATE: ____________

Make checks payable to: The Winner's Circle Running Club. Mail To: Race Against Extinction, C/O Bob Manning, 1 Lorum St., Newburyport, MA 01950. For more information call Bob Randall @ (978) 346-9240.

Click here for Race Against Extinction race/walk information.