The MOP Run entry form  Sat, June 24, 2006   8 AM

This is not an on-line form. You can fill out the information, then print out the entry and mail it in. *
Last name today's date
First name Phone
Address Email
City

Age (on 12/31/06)

State Sex male female
Zip Amt enclosed
       

($8, after June 9: $10), checks payable to Orienteer Kansas; send to Orienteer Kansas, 2223 Westchester, Lawrence, KS 66049.

Waiver of Liability - I, the undersigned, know that Orienteering, as an outdoor action sport, carries risks of personal injury. I know that there are natural and man-made hazards, environmental conditions and risks which, in combination with my actions, can cause me serious injury. I agree that I, as a participant, must take an active role in understanding and accepting these risks, conditions and hazards. I also agree that I, and not the organizers and officials of this event, Orienteer Kansas, the City of Lawrence, the University of Kansas or any sponsors, am responsible for my safety while I participate in this event.

Signature_____________________________________________ Date ___________________
If under 18, a parent or guardian must also sign_________________________________________