Forest City Road Races Entry Form

Marathon (8 am)	Marathon Relay (8 am)	Half-Marathon (8 am)
10k Open Run (9 am)	5k Run (8:30 am)	5k Walk (8:30 am)
5k Wheelchair (8:30 am)	2.5k Run (9:30 am)

Surname:

First Name:

Male:Female:

Address (include apt.#, R.R.#):

City/Town:

Province/State:

Country:

Postal Code/Zip

Phone Number (Area code/Phone):

Email:		T-shirt size: S M L XL
Age on Race Day:	Date of Birth (mm/dd/yy):

I am unable to collect donations but would like to support the Thames Valley Children's Centre (TVCC). (Tax receipts issued for donations $10 and over.)	TVCC Donation: $
	Entry Fee:$
Payment: Mail cheque or money order payable to Forest City Road Races to Forest City Road Races c/o Thames Valley Children's Centre, 779 Base Line Rd. E., London, Ontario, Canada N6C 5Y6
	Total:$

SORRY NO REFUNDS OR TRANSFERS!

WAIVER: In consideration of your acceptance of this entry, I the undersigned, intending to be legally bound, hereby, for myself, my family, my heirs, executors, and administrators, forever waive, release and discharge any and all damages and causes of suit or action, that I may at any time have against the Thames Valley Children's Centre, the Corporation of the City of London, The University Of Western Ontario, the London Pacers Running Club, the Forest City Road Races and it's organizing committee, and all clubs, associations, sanctioning bodies, sponsoring companies, participants, competitors, entrants and all their respective agents for any death, injury, loss or damage occurring prior to, during or subsequent to the event, to my person or property as a result of participating in this event. I attest and verify that I am fully aware of the physical risk of injury or death involved in participating in this event. I also authorize officials to utilize any photographs and video of my participation in the event for any and all purposes. By submitting this entry, I acknowledge having read, understood, and agreed to the above waiver. We appreciate your support of Thames Valley Children's Centre through your contribution to Forest City Road Races. We treat your personal information with respect. We do not rent, sell or trade our mailing lists. The information you provide us will be used to provide tax receipts, to contact prize winners, where applicable and to keep you informed of our events and fund raising opportunities in support of the Thames Valley Children's Centre. If at any time you wish to be removed from our list, simply contact Community Relations 519-685-8675 or via email at jackiep@tvcc.on.ca

Signature (Parent or Guardian if under 18):______________________________ Date:_______________________

Click to clear the form

Pledge Form

100% of pledges go to the Thames Valley Children’s Centre. Runners should bring all collected pledges along with pledge forms to the pledge desk on race day. If runners have not collected all pledges, please inform the pledge desk of the amount raised and submit a cheque or money order with the pledge forms by July 1, 2008 to: Forest City Road Races, c/o Thames Valley Children’s Centre, 779 Baseline Road East, London ON N6C 5Y6 (Tax receipts issued for donations $10 and over.)

Name of Participant:________________________________________________

Address:____________________________________________________________

Postal Code:____________________________ Phone #: ______________________

Sponsor's Name	Sponsor's Address	Postal Code	Phone	Amount Pledged	Paid








			Total Pledged
			Amount Remitted