(print this page and mail it with your registration fee to:
John Trigg Ester Library, attn: Readers on the Run, PO Box 468, Ester, AK 99725)

OR drop the completed form & payment off at Beaver Sports, the Ester library, the Ester post office bulletin board, the Golden Eagle Saloon, Gold Hill Liquor & Gas, Goldstream Sports, Toy Quest, or Gulliver's. (Please put in an envelope addressed to Readers on the Run)

Registration fees & shirts:

before October 8, without -t-shirt: $10
before October 8, with t-shirt: $20

October 8-10, without t-shirt: $15
October 8-10, with t-shirt: $25

additional t-shirts or for nonparticipants: $15
longsleeved t-shirts (men's supply limited): $20
sweatshirts (2008 design only, limited supply): $35

Participant information:

Name:

Mailing Address:

phone number:

e-mail:

Age on race day:

Age class (circle one): 9-15 - - - 16-20 - - - 21-35 - - - 36-50 - -- - 51-69 - - - 70+

t-shirt size: S --- M --- L --- XL --- XXL (youth / adult)

Bib # will be assigned at check-in. Please pick up your packet, with bib, at check-in, starting 10 am at race start point--library gazebo on Village Road, Ester, Alaska)

NOTE: Risk waiver must be signed before entry can be processed.

Parent/guardian must sign for entrants under 18

By signing below, I accept and agree to the following conditions:

Running is an action sport with hazards and risks which can cause me severe injury or death. In consideration for my participation in this event, I understand and accept the responsibility for these risks, conditions, and hazards. I hereby release and waive any claim I may have against the organization and people conducting this event--the Ester Community Association and the Friends of the John Trigg Ester Library--for any injury, including death, which may come to myself (or my child) as a result in this event, including as a result of negligence of any person or entity.

Participant Signature:________________________________________

Date:___________________

Parent Signature:____________________________________________

Date:___________________

2nd Annual Readers on the Run poetry fun run, 11 am, Saturday, October 10

Contact: Ed Rouleau, 458-9550, or Deirdre Helfferich, 479-3368

(below to be filled out by JTEL; entrant please leave blank)

ENTRY#

AMT PAID

BIB#

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