Nookachamps 2007 Entry Form

Please print out entry form and release form to enter the Nookachamps Winter Runs and mail with your payment to the following address:

Nookachamps Winter Runs c/o FootwoRx
702 S. First Street
Mount Vernon, WA 98273

Or click here to register online at Active.com(fees apply)

First Name:

Last Name:

Middle Initial:

Female Male Age (Day of Race):

Address Line 1:

Address Line 2:

City: State/Province: Zip:

Country: Phone: Email:

Age Division - Check One:	14 & Under	15-18
	19-29	30-39
	40-49	50-59
	60-69	70 & Over

Distance:
Half Marathon 10KM Run

5K Run/Walk

Please also check if: Walking HM Walking 10K

Pre-registration deadline is January 5th!

Please indicate shirt size (Adult): S M L XL XXL

Fees Enclosed:	$10 Pre-Reg for 5K & 10K -DOES NOT INCLUDE SWEATSHIRT OR L/S SHIRT(before 1/5/08)	$15 Day of Race Entry fo 5K & 10K -DOES NOT INCLUDE SWEATSHIRT OR L/S SHIRT(after 1/5/08)
	$20 Pre-Reg for 1/2 Marathon -DOES NOT INCLUDE SWEATSHIRT OR L/S SHIRT(before 1/5/08)	$30 Day of Race for 1/2 Marathon -DOES NOT INCLUDE SWEATSHIRT OR L/S SHIRT
	$25 EXTRA for Hooded Sweatshirt (DOES NOT include race fee)	$15 EXTRA for Long Sleeve Shirt (DOES NOT include race fee)

In order for pre-registration to be complete, this form, along with the signed release must be mailed to the address above and received with payment before 1/05/08!

Go to Release Form.

Nookachamps Winter Runs c/o FootwoRx 702 S. First Street Mount Vernon, WA 98273

Nookachamps Winter Runs c/o FootwoRx
702 S. First Street
Mount Vernon, WA 98273