Fifth Annual Wilderness Run
A Benefit for the Aaron Verminski
Cross Country
Running Scholarship
Aaron Verminski was a standout runner at RFA and MVCC. He passed away in June 2003 at the age of
20. A scholarship has been established
in his name and all the proceeds benefit the Aaron Verminski
Scholarship Fund.
Open 5K Cross Country Run at
Staley
Registration:
Race Time:
Registration Fees:
$10 for students prior to August 9th
$12
for adults prior to August 9th
$20 for all runners registering on race
day
Awards:
Trophies
to the Overall Male and Female Winners; Medals to the Top 3 in each age group; Water Bottles for the first 100
entries.
(See directions to Staley Upper
Elementary on the back of this sheet)
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In
consideration of acceptance of this application, I the undersigned, intending
to be legally bound, hereby, for myself, my heirs, executors, administrators
and assigns waive and release any and all claims for damages I may have against
the Rome City School District, City of Rome, their representatives and
successors for any and all injuries suffered by me at any time throughout the
duration of the 2007 Wilderness Run.
Printed Name:
_______________________________ Age as of
Address:
__________________________________________
Sex: _________________
City:
Signature:
_______________________________________________________________
Parent Signature - if under
18):_______________________________________________
For Official Use Only
-----13 and under ___14-17 ___18-24 ___25-40 ___41+
Please make checks
payable to the Wilderness Run. Send to Ty Knamm, 8165 State Rte 28,
Directions to Staley
From NYS Thurway
Eastbound:
Take
From NYS Thurway
Westbound:
Take