Benefiting

Reach Out Lakota

Saturday August 14, 2010 8a • West Chester, OH

Start & Finish at Union Centre Clock Tower
Course Info4 Mile distance beginning and ending Awards to the top male
Categories Awards Results
at the Union Centre Clock Tower, directly behind and female racer, and top 2 male and female
Mojo Running. NOTE - Walkers may walk all or a finisher by category. Results will be posted at
portion of the course. Course Route and Informa- sprunning.com, RunMojo.com and
tion available at www.blvdblast.com BLVDblast.com. Categories~
14 & under
available through 11:59pm
Registration Online 15-19 30-39 50-59
Wednesday August 11, 2010 getmeregistered.com
20-29 40-49 60+
must be postmarked
Registration by Mail or in Person Race Day Schedule
by Wed August 11, 2010. Send Registration with 7a Check In
fee to~ 8a Blast Off!
Check payable UCBB4 8:45a Little Feet Blast off! Kids Fun Run
c/o Mojo Running Store 9a Post Party & Awards
9318 Union Centre Blvd
West Chester OH 45069 S P O N S O R S
Registration Race Day at the Union Centre Clock
Tower at 7:00a

Packet Pick Up Mojo Running Store Friday 3p-7p

Phone 513.948.1100

Individual Registration Form

T-Shirt (Included if Register by July 30)
� Runner ($20) � Walker ($20) � Blaster-10 & under ($10) Circle Size
Men M L XL XXL
Team Name Women S M L XL
Youth M L
I am unable to participate but would like to make a
Sex � M � F Age as of August 13, 2010
donation of $_____________
Name Waiver Statement
In consideration of Registration, I, the undersigned, assume full and complete responsibil-
ity for any injury or any accident which may occur during the event or while I am on the
Address premises of the event. I hereby release and hold harmless the sponsors, promoters, and
all other persons and entities associated with the event. I assume the risk associated with
City St Zip this event including but not limited to falls, contact with other participants, the effects of
weather, the conditions of the road, etc., such risk being known and understood by me.
Fees are not refundable. I attest that I am physically fit and sufficiently trained to participate
Phone in this event. I have read the foregoing and certify my agreement by this signature or my
parents or guardian.
Email Participant Signature (or parent if participant under age of 18)