For more information, go to www.runlhh.org.

Make check payable to: American Heart Association
Mail to:
Lawyers Have Heart 10K
PO Box 5341
Rockville, MD 20848-5341

Fax credit card entries to (301) 871-0006.
Entries must be received by Wednesday, June 11! You can still register during packet pickup and in the morning of June 14 - just print out this form and have it ready when you come in!

Please fill out this form completely and legibly (print!) and sign the waiver before mailing or faxing.

____ I would like to volunteer.
____ I am a ChampionChip owner, and I am deducting $1 from my 
     entry fee. My ChampionChip number is:________________      
     (include full seven-character ID, i.e. CB73466)


Name: __________________________________________________________


Firm or Organization: __________________________________________


Address: _______________________________________________________


City: ___________________________ State: _______ Zip: __________


Sex:  M  F  Age on Race Day: _____   Event:  10K   3K Fun Walk


Check if you are a wheelchair athlete: _____


E-Mail Address: ________________________________________________


Phone: (____)_______________    T-Shirt Size:  M   L   XL


Are you a survivor of cardiovascular disease or stroke?  Y   N


Individual Categories:
____ lawyer        ____ legal assistant   ____ law librarian   


____ law student   ____ administrator     ____ legal secretary


Team Categories:
____ small law firm (less than 50 employees)   ____ government


____ large law firm (more than 50 employees)   ____ corporate


Team Name: _____________________________________________________
Please submit all team entry forms together, and make sure that
each of your teammates has put the SAME team name on their entry form!


Entry Fee:
Please note that the fees are the same for the 10K race and the 3K Fun Walk
$25 through May 31
$32 on or after June 1
$10 children 12 and under
Your entry fee includes a race t-shirt, ChampionChip rental (10K 
only), and post-race refreshments!


____ I am adding an additional contribution of $____ to my entry
     fee for the American Heart Association. Participants who
     contribute $100 or more will receive a commemorative gift.


Total enclosed or charged: $_____

 
Credit card: ____________________________________ Exp.__________ 
(Master Card or Visa)


Waiver:
I know that running a road race is a potentially hazardous 
activity and that 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 
complete 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 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 organizers of the Lawyers Have 
Heart 10K, the American Heart Association, Washington Harbour, 
Capital Running Company, USATF, and all other sponsors, their 
representatives and successors from all claims or liabilities of 
any kind arising out of my participation in this event or 
carelessness on the part of the persons named in this waiver. 
Further, I grant permission to all of the foregoing to use any 
photographs, motion pictures, recordings, or any other record of 
this event for legitimate purposes. I also agree to return my 
rental ChampionChip or pay $35 for its replacement.


Signed: 


________________________________________________________________
Parent or guardian if under 18 years of age          Date