2012 Danny Byard Race Entry Form
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  • 1. 2012 BLUE MOUND FALL FESTIVAL nd 22 Annual Danny R. Byard Memorial 5K and One Mile Fun RunSaturday, August 11, 2012Registration | 7:00–7:45 am | Wise ParkPre-register by mail until July 23, 2012CourseFlat and FastT-ShirtParticipants who register early will be guaranteed a t-shirt.TrophiesThe first three finishers ineach age group will receivea trophy.
  • 2. Male Age Divisions17 & under | 18–24 | 25–2930–34 | 35–39 | 40–4445–49 | 50 & overFemale Age Divisions17 & under | 18–25 | 26–3536–45 | 46 & overNo rain date or refunds ifcanceled due to weather.Entry Fee$15 Pre-Registration by July 23, 2012$20 after July 23rdInformation andTo Pre-RegisterByard Memorial Runc/o Chris HaleP.O. Box 65Blue Mound, IL 62513bluemoundfallfestival@yahoo.comName AgeAddress SexCity ZipShirt Size S M L XL 2XL Phone 3XL 5 K Race One Mile Fun Run and Walk DateEntrant’s SignatureParent/guardian signature for consent if entrant is under 18Waiver: In consideration of my entry, I for myself, my executors, administrators and assigns, do hereby release and dischargethe Blue Mound Fall Festival, City of Blue Mound, all Race Sponsors and workers for any injuries suffered by me at the event.I certify hat I have trained for a race of this distance and weather conditions, and I am physically fit for the race entered.