2007 ALCA/ YMCA Firecracker Run

Fill out the entry form below. If a participant is under 18 he/she must have a
parent signature the day of the race or a parent signed note.

Name: _____________________________
Age: _____ Sex: M F please circle
Phone Number: ______________________
E-mail: _____________________________

Shirt size: S M L XL please circle

Cost: Race $20 - Kids Fun Run $14

Emergency information for entrants and waiver form will be filled out day of race.

Return this form with check or money order postmarked by June 26, 2007 to:

Martin VanDenack
2959 Iroquois Trail
Hastings, MI 49058