2008 Hospital Hill Run

Participant Information
Event:

First Name:
Last Name:
Address Line 1:
Address Line 2:
City:
State:
Zip Code:
Email Address:
Contact Phone #:
Birth Date (yyyy/mm/dd):
Gender:	FM
T-Shirt Size:
Shoe Size:
Champion Chip #:
If you do not have a Champion Chip Number, one will be provided and needs to be returned at the end of the run. "I agree to pay $30 to the Hospital Hill Run if I lose or do not return my ChampionChip." YesNo
I have read the Hospital Hill Run waiver and agree to abide by all rules & regulations. Run Waiver YesNo