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ENTRY FORM
Stromsburg Swedish Festival Earl ‘Helge’ Byleen Road Race
June 21, 2008 - 8:30 a.m.
10,000 Meter, 5,000 Meter and One-Mile Fun Run
Entry fee - $10.00 if postmarked by June 14, 2008. $15.00 after
that date.
(Make check payable to Sherry Oberg, Chairman, and mail to 12605 I Road,
Stromsburg, NE 68666)
Check one: 10,000 Meter Race ______ 5,000 Meter Race ______ 1 Mile Fun Run______
Course Records: (Men's 10K-32:06) (Men's 5K-15:45) (Women's 10k-37:14) (Women's 5K-18:16)
$100 Cash Prize or merchandise certificate given to a male and female setting new course record in the 5K or 10K
Name _______________________________ Sex ________ Age on 06-21-08 __________
Mailing Address _________________________________ Phone ____________________________
City ______________________ State _____ Zip _________ Circle T-Shirt size: S M L XL
In consideration of your acceptance of my entry, I hereby for myself, my heirs and executors, waive and release any and all rights and claims for damages against the Stromsburg Chamber of Commerce, the City of Stromsburg, and the road race officials for any injuries suffered by me in connection with this event. I further certify that I am in good enough physical condition to participate in this event.
Signature _____________________________________ Date
If under 19, signature of parent or guardian