Pancake Day 2010 5K & 1 Mile Fun Walk Registration Form   Last Name _______________________________________ First Name _______________________________________ Age Day of Event ________ Date of Birth (m/d/y) ________ Sex: ___Male ___Female Race: ___5K ___ Fun Walk Shirt Size: ___Small ____Med ____Large ____X-Large Street Address ____________________________________ City, State, Zip ___________________________________ Phone [____] ____________________________________ E-mail __________________________________________ "I, for myself, heirs and assignees, hereby release the race director, Sabina 2000 organization, East Clinton Schools, Lions Club, all race sponsors, and all individuals associated with this event (Pancake Day 2010 5K/1mi. Fun Walk) and their representatives from any and all claims that may arise as a result of my participation. I certify that I am physically fit and assume all risks associated with my participation."   Signature _________________________________________ Parent/Guardian ____________________________________ (required if participant is under age 18)