Share |

Saturday, June 24, 2000 -- Bramwell
WV-VA Coal Shuttle Run 3.5 & 7 Mile Races

Make checks payable to: Bramwell Volunteer Fire Department

Mail entry form to:
WV-VA Coal Shuttle Run
Box 128
Bramwell, WV 24715

Click here to return to the race Details Page


CHECK EVENT:  3.5 Mile Run_____  7 Mile Run_____


NAME_______________________________________SEX_____AGE________


ADDRESS_______________________________________________________


CITY_______________________________________STATE____ZIP_______


PHONE_________________________________________________________


Check T-Shirt Size:  Med____  Large____  X-Large____
WAIVER: The above entrant releases and holds harmless the Bramwell Volunteer Fire Department and officials of the 2000 WV-Va Coal Shuttle Run from all claims of injury or damage resulting from participation in the above events. I also give my permission for the free use of my name and picture in any broadcast, telecast, or other written account of the aforementioned events. I am in proper physical condition to participate in this event. I assume any risk, whether resulting from negligence or otherwise, associated with my participation with this event.
_________________________________________________________
SIGNATURE  Parent or guardian MUST sign if under 18  

___________________________
DATE