Entry Fee: Entry fees are nonrefundable

(Please check appropriate box)

  6K Run                      6K Walk

$12 before 7/30/11     $15 after 7/30/11

 1 Mile Run                1 Mile Walk

$12 before 7/30/11     $15 after 7/30/11

 T-Shirt Size: (Please check appropriate box)

 2X           XL                    L              M             S                              Youth (10-12)

Disclaimer: The undersigned hereby agrees to hold harmless the sponsors for any injuries to themselves before,
during, or after the Nautical Race, and specifically do not hold the sponsors responsible for condition of the course of said race.

_____________________________________________

(Signature)

If under 18, parent or guardian must also sign.

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Entry Form: Mail Entries to: Rob Kortman. 5915 US 23 N, Rogers City, MI 49779. 
For More Information call: 989-734-4691 or email: coachrck@yahoo.com  

_____________________________________________________
Name(Last, First, Middle Initial)                                Address

_______________________________________________________________
City                                                     State                                        Zip

________________________________________________________________
Phone #                                               Age                Sex      e-mail address

 Case of emergency, notify:____________________________

Phone #___________________

 Beneficiary: RCHS X-Country Team
Make Checks Payable to: Nautical Run