All entrants: please fill in this section

Name:   

Address:  

City:   State:   Zip: 

Email Address: Phone:

T-Shirt Size:  S M L XL

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Runners Only

5 Mile Run-prizes given to fastest in each age/gender category       

Male        Female        Age: 

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Walkers Only

3 Mile Walk-prizes given for those with actual time closest to estimated time 

Estimated Time:      Minutes  Seconds

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All participants

By checking this box, I hereby for myself, executors and administrators, waive any and all rights of claims for damages I may have against the County of Mono, the Humboldt Toiyabe National Forest, Twin Lakes Resort, Twin Lakes Homeowners Association, the Bridgeport 4th of July Committee, Coleville High School or any individuals associated with the Bridgeport 4th of July Road Race for any and all injuries sustained by me in this event.  I attest and verify that I am physically fit and have sufficiently trained for this event.