Print this form, Make check and mail to: Diehl's Cider Mill 1479 Ranch Rd. Holly, MI 48442

Name:____________________________________________________

Address:__________________________________________________

City:_________________________State:______Zip:______________

Phone:____________________________________________________

Age on Sept. 26__________ SEX: M F Event Entered:   1 Mile Fun Run  *  4 Mile Run

Shirt Size: Youth * Small * Medium * Large * Extra Large * Extra Extra Large

DISCLAIMER: (must be signed) I hereby release all participating groups, sponsors and persons officially connected with the Ciderfest Run from any and all liability from any injuries or damages whatsoever arising from my participation in the event.

Entrant's Signature______________________________________________________

Parents Signature (if entrant is under 18)______________________________________

 

 

 

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