5th Annual PADDEN MUDFEST
Sunday, November 4, 2007
10:00 AM
Lake Padden Park
Bellingham, WA

Entries will be limited to 150 runners, so early registration is encouraged. Please send completed entry form to: Padden Mudfest
2567 Woodbine PL
Bellingham, WA 98229

Name__________________________________ (Circle) Male / Female

Address:_______________________________________________________________________

City:______________________ State/Province:__________ Zip/PC:_________________

Phone:______-_______________ Date of Birth: __/___/____ Age on Race day:_________

e-mail:_______________________________________________________________

Early Start (For those likely to take more than 80 minutes):    Yes        No

Hat: Yes No

Fee (Circle one): $10 (Non-GBRC Member with no hat)
      Free (GBRC Member with no hat)
      $20 (Non-GBRC Member with hat)
      $10 (GBRC Member with hat)

Please make checks payable to Greater Bellingham Running Club (GBRC)

Release (each participant must sign)
“In consideration of the acceptance of my entry, I for myself, my heirs, executors, administrators and assigns waive, release and discharge any and all rights and claims or damages against the Greater Bellingham Running Club, its members, race workers, the State of Washington, Whatcom County Parks, and all sponsors for claims arising from my participating in the Padden Mudfest. I attest and verify that I have full knowledge of the risks involved in this run and that I assume those risks, and that I am physically fit and sufficiently trained to participate in this run.”

Signature:____________________________________ Date:__________________________

Parent's Signature if athlete is under 18:_____________________________________________