2011 Olympic Day Run Entry Form .

“The Magic of the Mile”
Come celebrate the Olympic Spirit
At The 25th Annual Olympic Day Run 2011

How long does it take you to run, jog, walk a mile?
How many calories do you burn when you run, jog, walk a mile?
How do you feel when you run, jog, walk a mile? |

Date: July 9, 2011
Time: Run, jog, walk in your group:
5:00pm (20min. per mile group);
5:30 (15min. pm grp);
5:45 (10min pm grp);
6:00pm (7min pm grp);
6:15pm (6 min. pm grp)
Place: The St. Croix Educational Complex High School Track

Who: Adults and children of all ages!

One-mile run/jog/walk • Open to all ages and ability levels • Awards to each finisher,
free Olympic Day tee-shirts, Olympic certificates, and pins to the first 100 finishers!

FREE! FREE! FREE!

WIN RAFFLE! WIN RAFFLE! WIN RAFFLE!

To register:
o Stop by Stamina Sports (old Bingo building in Est. Orange Grove)
o Go online to: http://virginislandspace.org or http://virginislandsolympics.com or
o Bring the completed form below on run day

Question Title

* Please complete below to register for the Olympic Day Run:

1. Number:

2. Last Name:

3. First Name:

4. Age:

5. Sex:

6. Date of Birth:

7. Mailing Address:

8. Tel.#:

9. Federation:

10.Email:

11. Your weight (lbs.)

Question Title

* In consederation of accepting this entry, I, the undersigned, intending to be legally bound, hereby for myself, my heirs, executors and administrators waive and release all rights and claims for damages I may have against the organizer of this event and any and all sponsors, the Virgin Islands Olympic Committee, The Virgin Islands Track and Field Federation, The Virgin Islands Pace Runners, The Carabola Golf Course adn their employees, officers, volunteers, of any and all injuries suffered by me in said event. I attest and verify that I am physically fit and have sufficiently trained for the completion of this event (which may be in high heat and humidity on an uneven surface) and my physical condition has been verified by a licensed medical doctor. Further, I hereby grant full permission to any and all the forgoing to use any photographs, videotapes, motion pictures, recordings and other record of this event for any legitimate purpose.

Signature:

Date:

Signagure of Parent/Guardan (if you are under 18):

Date:

FREE! FREE! FREE!
call: 340-643-2557 for information...
Logon to: http://virginislandspace.org
Organized by: The Virgin Islands Pace Runners...
Sanctioned by: The Virgin Islands Track and Field Federation...
For: The Virgin Islands Olympic Committee and The International Olympic Committee...