The First Durham Reunion Entry Form 2013

WHAT: The First Durham School Reunion 2Mile Run/Walk for the benefit of the Durham School Track and Field facility…

WHEN: On the occasion of the 50th Anniversary Durham High School Reunion
8am August 31, 2013 This is The 50th Anniversary...Clem Haskins edition...

WHERE: Campbellsville, Kentucky, Elementary School (Durham) School Track

WHO: For all alums of the Durham School, family, friends, the general community
ORGANIZED By: Durham School Reunion Committee/The Virgin Islands Pace Runners

SPONSORS: Sponsored by local commercial vendors, pledges from Durham Alums

SUPPORT: With permission of the Campbellsville Police Department, available Emergency Service entities, volunteers

ENTRY FEE: FREE! FREE! FREE!

Question Title

* My Category:

I am Durham HS Graduate

I was a Durham student?

I was on the Durham staff

Graduated? what school?

Staff? what school?

I am a student of this school

This is my college

My Profession

Business

My Sport

My Church

My Club

My Organization

My Weight

I am a graduate of what college?

RELEASE—WAIVER—STATEMENT OF FITNESS
I entering this footrace/run/walk, hereby attest that I have trained adequately for and am in proper physical condition, as ascertained by a licensed physician, to run/walk approximately 2 miles in high heat and humidity on public/private paths, roads and grounds. I recognize that there are/and could be numerous unsafe areas of both the roads and the grounds, and that I am at constant risk of personal injury. I know that it is my responsibility to carefully walk the course and adjacent property beforehand to familiarize myself with them, as well as to watch where I am going the entire time that I am on run/walk course. I specifically waive my right to a trial by jury, and accept as a condition for entry that any claim I may have against the race/walk/run organizers will be settled through binding arbitration. I further release all sponsors, volunteers and organizers from all claims resulting from loss, injury or illness resulting from my participation in this run/walk and give permission to use my name and/or picture in any account of this race.

Question Title

* PERSONAL INFORMATION

LAST NAME:

FIRST NAME:

SEX:

AGE;

MAILING ADDRESS:

PHONE:

EMAIL ADDRESS:

SIGNATURE:

DATE:

SIGNATURE OF PARENT IF YOU ARE UNDER 18:

DATE:

Question Title

* We are recording the history of Durham school...please tell us about yourself and some of your memorable times associated with Durham…Tell us about your connection with Durham School…

Question Title

* I DEDICATE MY DURHAM 2MILE RUN/WALK TO:

10.