-- ENTRY FORM May 3, 2008 - Adamant Black Fly 4 Mile Run --
  
  Name (Pls. Print) __________________________________

  Mailing Address ____________________________________

  City _____________________________   State ________

  Zip Code ________________________

  Sex:   M    F   Age on Race Date ____ 

  Birth Date _________________________________________


  Telephone No. ________________________

I know that running a road race is a potentially hazardous activity. I should not 
enter and run unless I am medically able and properly trained. I agree to abide 
by any decision of a race official relative to my ability to safely complete the 
run. I assume all risks associated with running in this event including, but not 
limited to, falls, contact with other participants, contact with dogs and leashes, 
the effects of the weather, including heat and/or humidity, traffic and the con- 
dition of the road and other running surfaces, all such risks being known and 
appreciated by me. Having read this waiver and knowing these facts and in con- 
sideration of your accepting my entry, I, for myself and anyone else entitled 
to act on my behalf, waive and release the Central Vermont Runners, Adamant Cultural 
Foundation, Behre Piano Assoc., the Adamant Coop and all sponsors, their represen- 
tatives and successors from all claims of liabilities of any kind arising out  
of my participation in this event even though that liability may arise out of 
negligence and carelessness on the part of the persons named in this waiver.


Signature _____________________     Date ___________

____________________________________________________
Signature of parent or guardian if participant
under 18 years of age