5K Run ______ 10K Run ______ 1 Mile Fun Run ______ T-shirt size:   XS    S    M    L    XL

Mail to:

   Kathy Pressley                               Make checks payable to: Historic Roswell Kiwanis Foundation

   Fidelity Bank
   1325 Hembree Rd                                 Cash ______ Check ______ Amount Paid: $____________
   Roswell, GA 30076

Waiver/Release: In consideration of acceptance of this entry, I waive any & all claims for myself and my heirs against the officials, sponsors (Including Historic Roswell Kiwanis Foundation, Inc, and/or the Kiwanis Club of Historic Roswell, Inc., their Directors and members), hosts, volunteers or any other persons in conjunction with the 2012 Historic Roswell Kiwanis Spring K Classic. I understand that running a race can be hazardous. I certify that I am in proper physical condition to participate in this event. I also give my permission for the use of my name and picture in any media or other account of this event.

______________________________             __________________________________
Runner’s Signature                                                       Signature of Parent/Guardian if under 18