Name:  
      Address:  
         City:  

        State:     Zip: 
Home Phone:  Date of Birth:  Age on race date: 
Cell Phone:     
Email Address:  	   
	   Race Distance: 5K Run 5K Walk 10K Run 10K Walk
	   Race Entry: $30$20(Child 15 & under) 
	   Late Entry(Postmarked 6/4-6/30/10): $35 $20(Child 15 & under) 
	   Race Day Entry: $40 $20(Child 15 & under)
	   Gender: M F
           Adult T-shirt Size:  S M LG XL
	   Child's T-shirt Size:  S M LG XL 
			

Waiver Must Be Read and Signed Before Mailing:
In consideration of my entry, I myself, heirs, executors, administrators, and assigns waive and release any and all rights and claims against the Sacramento Firecracker 5K/10K, also any related coordinators, sponsors, volunteers, supporters,Ultrarunner.net, Lake of the Sky Trail Runners Running Club, City of Sacramento, and employees of Sacramento, California. I further attest that I am physically fit and have trained for this said event. I also agree to any/all medical treatment to be administered to me during or after completion of this event. I also waive any negative or positive input to the above race director during this event and will withdraw at the request of the above. I also accept full responsibility for my actions, etc. All fees are nonrefundable. Shirt/sizes not guaranteed for late or race day entries.

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Signature                            Date