2009 Entry Form

Print this form out and mail information to:
Mentor Pack Club
PO Box 14
Mentor, Ohio 44061

Greater Cleveland Cross Country Camp Entry Form-Please Print

Name: _____________________________
Age:______ Sex:______ Grade: _____
Address: ___________________________
City: ___________________ Zip: ________
Phone: ____________________________
School:____________ 5K PR:__________
Shirt Size: S     M     L     XL 
Beginner         Intermediate         Advanced
________________         _________________
Signature                           Parent Signature

Emergeny Contact Information:

Name __________________________________

Phone _________________________________

Entry and release of all claims--In consideration of the acceptance of my entry in the 2008 Greater Cleveland Cross Country Camp, I undersigned intending to be legally bound for myself, my heirs, my executors, and administrators, waive and release any and all claims for losses and damages I may have against the Greater Cleveland Cross Country Camp, any sponsors, officials and members of the said event and further agree that the above person will be responsible for the loss of personal items from this event. I represent that I am physically fit and have adequately trained to participate in this event, and have full knowledge of the risks involved in this event.

Make checks payable to Mentor Pack Club
Price: $55

Note: No Refunds