1. ogwood
mber 11, 2
010 at Camp D
Saturda y, Dece
5K run — 10:00 am
Entry Fee — $20
($15 if receive by Dec. 10) am
— 10:15
lk
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run $10
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704-966-989
8—Leslie
www.SFTrotary.com
Rotary Club of Sherrills Ford-Terrell
3rd Annual Reindeer Romp at Camp Dogwood on Saturday, December 11th at 10am
Please read and sign. In consideration of my entry, I, _________________________________________, intending to be legally bound for myself
and anyone entitled to act on my behalf, do hereby release and discharge and any and all sponsors, contributors and organizers including but not
limited to the Rotary Club of Sherrills Ford-Terrell, Rotary International, the North Carolina Lions Club Foundation, Lions Club International and
Camp Dogwood from any and all liability arising from any illness, injury or damages I may suffer as a result of my participation in the 3rd Annual
Reindeer Romp events. I provide and certify my compliance by my signature below. If participant is under 18 years old, I certify by my signature that
he or she has permission to participate, is in good physical condition, and that officials may authorize emergency medical treatment in the event of
injury or illness. I understand that there is no refund due to me for any reason other than complete cancellation of the event. This release and
waiver extends to all claims of every kind whatsoever, foreseen or unforeseen, known or unknown. I also give my permission for the free use of my
name and pictures in any broadcast, telecast, or written account of the race. Must be signed to be valid.
Signature__________________________________________________________________________________Date___________
(parent or guardian if under 18 years old)
Camp Dogwood – 7062 Camp Dogwood Dr, Sherrills Ford NC (near the intersection of Mt Pleasant Rd and Little Mountain Rd)
REGISTRATION FORM (Please complete this form for each participant)
Choose one:
_____ 5K Run -- $20 per runner ($15 if register by December 10 – must be postmarked by December 6)
_____ 1 Mile Fun Run / Walk -- $10 per participant
Name: ________________________________________________________________________ Age: _________________
Address: ________________________________________________________________________________________________
Phone __________________________ E-mail: ________________________________________________
Emergency Contact: ________________________________________________ Emergency Phone: ________________________
T-shirt size: . Youth S M L XL (circle one) . Adult S M L XL (circle one)
Please make your check payable to the Sherrills Ford – Terrell Rotary Club and include the registration fee with this signed registration form.
Mail to: Sherrills Ford – Terrell Rotary Club, PO Box 51, Sherrills Ford, NC 28673 (postmarked by December 6)
Drop off at: Sherrills Ford – Terrell Fire and Rescue on Slanting Bridge Rd

2. wood
1, 2010 at Camp Dog
y, D ecember 1
Saturda
5K run — 10:00 am
Entry Fee — $20
($15 if receive by Dec. 10)
:15 am
alk — 10
n/w
n ru $10
n’s progr
ams
1 mi le fu Fe e—
benefit
local chil
d re
E ntry
To
a m
s at 9:00
k-in begin
T-Shirts
& Hot C
n & chec hoco
R egistratio late & T
rophies
704-966-989
8—Leslie
www.SFTrotary.com
Rotary Club of Sherrills Ford-Terrell
3rd Annual Reindeer Romp at Camp Dogwood on Saturday, December 11th at 10am
Please read and sign. In consideration of my entry, I, _________________________________________, intending to be legally bound for myself
and anyone entitled to act on my behalf, do hereby release and discharge and any and all sponsors, contributors and organizers including but not
limited to the Rotary Club of Sherrills Ford-Terrell, Rotary International, the North Carolina Lions Club Foundation, Lions Club International and
Camp Dogwood from any and all liability arising from any illness, injury or damages I may suffer as a result of my participation in the 3rd Annual
Reindeer Romp events. I provide and certify my compliance by my signature below. If participant is under 18 years old, I certify by my signature that
he or she has permission to participate, is in good physical condition, and that officials may authorize emergency medical treatment in the event of
injury or illness. I understand that there is no refund due to me for any reason other than complete cancellation of the event. This release and
waiver extends to all claims of every kind whatsoever, foreseen or unforeseen, known or unknown. Must be signed to be valid.
Signature__________________________________________________________________________________Date___________
(parent or guardian if under 18 years old)
Camp Dogwood – 7062 Camp Dogwood Dr, Sherrills Ford NC (near the intersection of Mt Pleasant Rd and Little Mountain Rd)
REGISTRATION FORM (Please complete this form for each participant)
Choose one:
_____ 5K Run -- $20 per runner ($15 if register by December 10 – must be postmarked by December 6)
_____ 1 Mile Fun Run / Walk -- $10 per participant
Name: ________________________________________________________________________ Age: _________________
Address: ________________________________________________________________________________________________
Phone __________________________ E-mail: ________________________________________________
Emergency Contact: ________________________________________________ Emergency Phone: ________________________
T-shirt size: . Youth S M L XL (circle one) . Adult S M L XL (circle one)
Please make your check payable to the Sherrills Ford – Terrell Rotary Club and include the registration fee with this signed registration form.
Mail to: Sherrills Ford – Terrell Rotary Club, PO Box 51, Sherrills Ford, NC 28673 (postmarked by December 6)
Drop off at: Sherrills Ford – Terrell Fire and Rescue on Slanting Bridge Rd