Potomac Overlook Trail Runs
March 11, 2006
Release and Registration Form

Name:______________________________ Age:_____ Male:__ Female:___

Address:________________________________________________________

City:_________________________________ State:_____ Zip:_________

Phone_________________________E-Mail:___________________________

Signature:______________________________________________________

T-shirt Size: S ____ M ____ L ____ XL ____

Planned Event: 4K _____ 8K _____ 12K _____ 
       (Distance can be changed at the event.}

Release and Waiver:  In consideration of the acceptance of my entry, 
I for myself, my heirs, executors, personal representatives, and 
successors, do hereby release and discharge Virginia Happy Trails 
Running Club, Potomac Overlook Regional Park, Donaldson Run Recreation 
Association, Food for Others, Inc., their officers, directors and 
volunteers, and all other sponsors of the event of any and all claims 
for damages personal injury, or death, and any and all demands, suits, 
causes of action whatsoever in any manner arising out of my 
participation in said athletic event.  I attest and verify that I have 
full knowledge of all risks involved in this athletic event, and I 
certify that I am physically fit and sufficientlytrained to participate
in this event.  In addition, I hereby consent to the sponsors to use any
photographs, motion pictures, videos or other records of this event for
any legitimate purpose.

This document is a legal release and must be signed before mailing.

Unfortunately, I will be unable to participate this year.  Please 
accept my tax-deductible donation of $______ to help feed the hungry.

Entry fee is $18 ($20 on race day). You may pay with a check payable to 
"FOOD FOR OTHERS" or you can use a credit card by filling in the following:

Visa____ MasterCard____ Number________________________________________
            					e.g.: 1234-5678-9123-0000

Expiration ____________ Card holder name _____________________________
           e.g.:  09/02

Card Holder's Signature____________________________________  

Send completed entry form to "FOOD FOR OTHERS" by March 6, 2006 to:

Food for Others
2938 Prosperity Ave
Fairfax, VA 22031.