Official Entry Form

Chattanooga Half Marathon &

Arthritis Foundation 5k Run

Make checks payable to:  Arthritis Foundation

Mail to:  Arthritis Foundation, 715 Broad St., Suite 201, Chattanooga, TN 37402

You may register online at

                            Postmarked             Postmarked       After &               

Check applicable boxes    By 12/31/03              By 2/29           Day of Race         

Half Marathon           $30                     $35                   $40              $_________

5k Run                                                 $15                    $20             $_________

Raise $50+ in pledges for the Arthritis Foundation                            +$_________

and receive a FREE event logo sweatshirt.                                 Total $_________

Entry fees are non-refundable Please print clearly

First Name_______________________Last Name______________________

Address_________________________________________________________

City_________________________________State_______Zip______________

Daytime Phone (       )_________________Evening Phone (       )_____________

Age (on race day)_________Sex:   Male     Female          T-shirt size:   L     XL

*I would like the medical personnel of the Chattanooga Half Marathon & Arthritis Foundation 5k Run to be aware of specific medical problems.  Please list________

_______________________________________________________________

_______________________________________________________________

Please read wiaver and sign:  I know that running is a potentially hazardous activity, and 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 this event.  I assume all risks associated with running this event, including but not limited to falls, contact with other participants, the effects of weather, including high heat and humidity, traffic, and conditions of the road, all such risks being known and appreciated by me.  Having read this waiver and knowing these facts, and in consideration of your accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release the Chattanooga Track Club, Road Runners Club of America, the Arthritis Foundation, and all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event even though this liability may be the result of negligence on the part of the persons named in this waiver.  I understand that bicycles, skateborads, baby joggers, rollerblades, animals and headsets are not allowed in this race, and I will abide by these guidelines.

Participants Signature__________________________________Date________

                                         (If under 18, parent or guardian's signature)

Guardian Signature____________________________________Date________