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Saturday September 6, 2014

9:30 AM

Bar Anticipation, Lake Como, NJ

Lake Como, NJ

Please select from the following categories:

5K	12th Annual Fallen Heroes 5K race. Bar A, Lake Como Categories: Fire, Police, EMS, Lifeguard, Teams. Barbecue and beverages after race	$25.00
5K	USATF	$22.00
1 mile	Walk/run	$12.00
Kids Race	Sprints	$12.00

Please provide the following information on the participant. Required fields are denoted by an asterisk *.

*First Name

*Last Name

*Gender

*Birth Date

YYYY

*Address

Address

*City

*State

*Zip

County

*Country

*Phone

*E-mail

A registration confirmation will be sent to this e-mail address


Waiver	In consideration of this entry being accepted I hereby for myself, heirs, executors, and administrators waive and release any claims I may have against any and all Parties, Groups, Organizations, Volunteers, Sponsors, and (or) any Representatives involved in Fallen Heroes 5K Memorial Run - ONLINE CLOSED for any and all injuries suffered by me in this event. I certify that I am physically able to compete in this event.
* I have read the above waiver and agree to terms

*Please choose your T-Shirt size:

YS YM YL S M L XL XXL

Are you a: Firefighter, Police Officer, Lifeguard, EMS, Military
Phone Number
*Event entered: 5K, Kids dash, 1 mi walk
*Entry fees: 5K $25 by 9/5/12, 5K $23 USATF by 9/5/12, 5K $30 after 9/5/12 and on race day, Kids dash $12
What is your USATF-NJ number?

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