Hosted and sponsored by Congratulations on your outstanding cross country season. You are invited to run at the Mississippi Meet of Champions and compete against the best runners in the state of Mississippi from both the public and private schools including returning female champion, Cory McGee and the returning male champion, Matthew Cameron. Date: Saturday, November 11, 2006 Location: Tatum Park, Hattiesburg, Mississippi Course: Grass, flat and fast Distance: Girls 5k; Boys 5k Time: 6:00 p.m. Girls Race; 6:30 p.m. Boys Race Awards: Top 15 runners will receive a cool-max T-shirt Entry Fee: $20.00 ENTRY FORM FULL NAME: ___________________________________________ AGE: ________ SEX: M F ADDRESS: _______________________________________________________________ CITY: ________________________________ ZIP CODE: ________________________ EMAIL ADDRESS: ______________________________________________________ PHONE NUMBER: ______________________________________________________ YEAR IN HIGH SCHOOL: ______ T-SHIRT SIZE: S M L XL BEST CROSS COUNTRY TIME IN 2006 SEASON: _________ DISTANCE: _______ Waiver/Agreement I know that running a road race is a potentially hazardous activity. I should not enter and run unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely compete the run. I assume all risks associated with running in this event including but not limited to: falls, contact with other participants, the effects of the weather, including cold, snow and/or ice, high heat and/or humidity, traffic and the conditions of the road, all such risks being known and appreciated by me. Having read this waiver, and knowing these facts and in consideration of your accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release the race organizers, its directors, officers, and staff and the city of Hattiesburg and its employees, and all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings or any other record of this event for any legitimate purpose. _____________________________________ ________________________________________ Signature Date Parent’s Signature (if under 18 years of age) Date All entries should be faxed to Yousri Elmejdoubi at 601-914-4669. Deadline is Thursday, November 9th at Midnight. For more information, contact Yousri Elmejdoubi at 601-914-3687 or yousri@ucoachrunning.com.