Little Moe 5K Walk/Run benefitting horse rescue at the CNYSPCA

Entry Form

Make check payable to CNYSPCA, and mail check and entry form to:
Little Moe Walk/Run, c/o Skanda Equine, 4000 Mosley Road, Cazenovia, NY 13035.

Name (First & Last): 
City:  State:  Zip:  Age:  Gender: 
Email:  Phone: 
Shirt Size: Small  Medium  Large  Extra-Large  Double XL

WAIVER (Must sign to participate): I do hereby absolve all race sponsors, volunteers, race officials, and organizers from all claims of damages, demands, actions, and courses of action whatsoever, in any manner arising or growing out of my participation in the Skanda Equine Little Moe 5K Walk/Run. I certify that I have prepared myself and that I am in adequate physical condition to participate in the event I have entered on September 14, 2013.

Signed   Date  

Parent (if under 18)   Date  
  If you unable to attend and want to donate directly to the Central New York SPCA, please check this box and send checks payable to the CNY SPCA to Skanda Equine at 4000 Mosley Road, Cazenovia, New York 13035.

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