San Gabriel Valley -Menudo Run Application- September 11, 2004

LOCATION - Legg Lake Park, Santa Anita Ave., South El Monte, South of 60 Freeway in L.A.
TIMES - Check in 6:30 a.m. Race 7:30 a.m. 5K Police, Fire, Corp. Teams 8:30 a.m. 5K/10K Open Competition
Just print this application an mail it to: P O Box 2422 Irwindale CA 91706

  • Pick up the registration packet on race day between 6:00 - 8:00 a.m.

  • Entry Fee: - Runners Pre-registration by mail $18.00 (including race shirt)

  • Late Entry Fee - $20.00 after August 24, 2002 and on race day.

  • Walkers - Pre-Registration $15.00 (including race shirt). Late entry fee - $18.00 after August 24, 2004, and on race day                                                                                                                                                          

  • For Fitness only. No awards. Cost includes liability insurance. Proceeds will benefit NLPOA a non-profit organization which supports Scholarships and the U.S. Marine Corps, Youth Leadership Program, (Devil Pups).

* Name: ____________________   ______________________                               RACE USE ONLY ___     ___    ___
                    Last                                             First                                  
* Address: ______________________________  City _______________ State _____  Zip _________

* Phone: (_____) ____________________  Age _____   T-Shirt Size  M____  L____ XL ____ XXL ____

* I will be running Open Competition   =   5K _____  10K _____ Just for Fun ______________________          


Male                                                                             Age and Division
__A______B______C_____D_______E______F______G______H_____I______ J_____K_______L______M__
 _0-14____15-18____19-24___25-29_____30-34___35-39____40-44____45-49____50-54___55-59___ 60-64____65-69_____70____

Female                                                                         Age and Division
__N______O______P______Q_____R______S______T______U______V______W______X______Y______Z__
_0-14_____15-18___19-24_____25-29___30-34____35-39____40-44____45-49____50-54____55-59____60-64_____65-69_____70_

Police/Fire Dept. Teams only: Dept. _____________________________________________________ 5K  
Div./Bur./Sta. _________________________________________________________________________
Enclosed is my check for _____ $18.00 for 5K/10K Entrance Fee (includes shirt, as supply allows)
                                              _____ $15.00 Fun walk (includes shirt, as supply allows)
Waiver
In consideration of this entry, I hereby for myself executors, administrators and assignees waive any and all right of claims for damages I may have against the N.L.P.O.A., Official time keepers, all sponsors, the county of Los Angeles Parks and Recreation, or any individual associated with said event for any and all injuries sustained by me in this event. I attest and verify that I am physically fit and have trained for this event. I grant full permission to sponsors and others to use photos, film, of my participation in said event without liability or obligation to me. In filling out this form. I acknowledge I have read and fully understand my own liability an do accept the restrictions.

Participant ___________________________________________________ Date _______________________
(If Minor, Parent or Guardian Must Sign)

ADVISE YOUR BUSINESS TO SPONSOR A MILE -$200.00
Contact: 626-480-3067 or 800-600-5273

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