22nd Annual Lake Benbrook Half Marathon and 5K

January 30, 2010

8:30 am start

Direction:  I-30W to Hwy183S to Hwy377S turn left on Winscott Rd. and right into Dutch Branch Park.  I-20W to Hwy 183S to Winscott Rd. turn left and right into Dutch Branch Park.

Awards:  Overalls/3 deep age groups and trophy for the most School Team Participants

Last Name: First Name:

DOB: Gender: Male Female T-Shirt: Small Medium Large XLarge XXL

Event: 5K Fees: $20 by January 22, $25 after January 22, Groups (5 or more) $15 by Jan.22.  

          Half Fees: $25 by January 22, $35 after January 22, Groups (5 or more) $20 by Jan. 22

                                                                                                                                                                     Name of School/Group Team:Post marked by Jan.22,2010 

Street: City: State: Zip:

 Email (Optional)   Phone:

 Signature:__________________________________________________________________________

To be signed by the athlete and/or parent guardian of athletes if under 18  

Waiver Form: Sponsors and officials of the Lake Benbrook Half Marathon/5K to be held January 30, 2010 are not held responsible from all damages or injuries incurred during or arising out of my participation in this event.  Also, I certify that I am in sufficient physical condition to participate in this event  The City of Benbrook and RunTIME Racing Services are not a sponsor of this event and is held harmless from all claims, suits, causes of action and liability arising out of the use and occupancy of all City of Benbrook park areas and facilities..

Packet pickup at Luke's Locker at Montgomery Plaza,  January 28-29, 2010

Make checks payable to Lake Benbrook Half Marathon/5K                  Mail to 3619 Byers Ave., Fort Worth, Texas 76107