Cambridge YMCA Family Center

Cambridge YMCA Family Center Red White & Run, 4mile Run and Walk Race Date: Friday, July 4th 2014, Race Site: Cambridge YMCA

Registration: Early Bird, May 12th – June 23rd On Time, June 24th – July 4th

Name______

Address______

City______State______Zip______

Date of Birth______Age as of 07/4/14______

Gender Male Female Phone Number______

T-Shirt Size: S M L XL XXL T-shirts are guaranteed to early bird registrations only and all others will receive a t-shirt on a first come – First sever basis with limited sizes and quantities available.

Select Race/Walk: 4mile Run 4mile Walk

Release of Responsibility: In consideration of being accepted to participate in the Cambridge YMCA Red White & Run. I assume all risks associated with running or walking this race. Having read this release, I waive and release the YMCA, its board of directors and all sponsors from all claims to liabilities of any kind arising from my participation in this event.

Participant Signature:______Date:______

Parent/Guardian Signature (If under 18) ______

Make checks payable to: Cambridge YMCA $20 Early Bird Registration (postmarked by 06-23-14) all others $30

Mail to: Cambridge YMCA Family Center • 1301 Clairmont Ave • Cambridge, OH 43725