2008 Butterfly Run
Registration Form

Entry Fee:  5K Run/Walk $15.00
		Children 12 & under $8.00 (includes a tee)
		Family rate $38.00 
		         (3 or more people in same family, maximum of 3 tees)
		Mile Fun Walk ($5.00, no tee)


To Enter:  Fill in form below.  Make checks payable to: 
			“Elizabeth Ciunci Scholarship Fund”.  
     
              Mail to:  Butterfly Run, 
                        5 Almy Dr, 
                        Malvern, PA 19355 
               
              or bring it with you to the race.  


For Info: Call Jackie Ciunci (610) 256-4710





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REGISTRATION – Butterfly Run 2008  (one form per person – Please WRITE NEATLY!!)


Name___________________________________  M_____ F_____      Age on race day _________


Address___________________________________________________     5K_____  or 1Mile_____


City______________________________________________  State________  Zip_______________


Fee: $______	Tee Shirt  (circle):  M    L    XL	Phone_______________   E-mail_____


I am unable to participate but would like to donate  $__________________________

     In consideration of the acceptance of this entry, I hereby, for myself, 
     my heirs, executors and administrators, waive and release all rights and
     claims for damages I may have against the organizers,  sponsors, volunteers,  
     officials and any other individuals associated with this event and will 
     hold them harmless from any injury suffered by me.  Also, none of the above
     are responsible for the loss of personal items nor any other form of 
     aggravation in connection with said event.  I understand that road racing is
     a potentially hazardous activity. I verify that I am physically fit to 
     participate in this event.  


Signature  (parent's if under 18)___________________________________________________