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<br /> <br />2nd Street W. <br /> <br />Highway 55 <br /> <br /> <br />T- <br />CD <br />>- <br />m <br />== <br />.c <br />= <br />::J: <br />-:- <br />- <br />en <br /> <br />c <br />c <br /> <br />E <br />- <br />CD <br />::> <br /> <br />2nd Street E. <br /> <br />en - en <br />>- en <br />CD - <br />U) CD <br />E ~ <br />m <br />a:: <br />10th SlE. <br /> <br />, <br /> <br />18th St. E. <br />~ <br /> <br />Minnesotals <br />Veteranls Home <br /> <br />- Visit www.gobblegait.com to register online - <br />Portion of online fee is donated to Hastings Family Service <br /> <br />Registration Form - Gobble Gait 2005 <br />Return to: Gobble Gait 2005, 925 Hwy. 55, Ste 201, Hastings, MN 55033 <br />Phone <br /> <br />Name <br /> <br />(Please Print) <br /> <br />Last <br /> <br />First <br /> <br />Address <br />Address <br /> <br />Sex: 0 F 0 M Age: <br /> <br />Entry Fees: 8K Before Oct. 31 $20.00 _ Nov. 1 - 23 $25.00 _ Raceday $30.00 _ <br />(T-shirt size: Adult MOL 0 X-L 0 XXL add $3.00 0) <br /> <br />Please make checks payable to: Gobble Gait <br /> <br />Waiver: I am entering this event at my own risk and assume all responsibility for injuries I may incur as a direct or indirect result of my partici- <br />pation. For myself and my heirs, I agree not to hold the participating sponsors and their directors, employees and/or agents responsible for my claim. <br /> <br />Signature <br /> <br />City <br /> <br />State <br /> <br />Zip <br /> <br /> <br />(Parent or Guardian Must Sign (f Participant is Under (8) <br /> <br />Signature <br /> <br />Entry Fees: 2K Before Oct 31 $7.00 _ (participat,ion ribbon) Nov. l-Raceday $10.00_ <br /> <br />(Parent or Guardian Must Sign (f Participant is Under (8) <br /> <br />GDI No. 45008 10f2005 <br />