Meet Information
25th Annual Armadillo Stampede
1 mile Fun Run/Walk
5K Run-Individual
5K Run- Super Squad
( 7-Person team)
male,female, or mix
Date May 3rd 2008
Time: 8 A.M.
Downtown Leesville in front of Post Office
Entry Fees:
* $10 individual per-registration
* $15 if day of the event
* $ 45 per super squad
* Entry fee includes free T-shirt
* With proof of AUSA membership $5.00 discount on all individual fees
Trophies for 1st, 2nd,& 3rd places
(male & female)
17 & under
18-34 and
35 & over age groups
To enter fill out this from & mail to
P.O. Box 2570, Leesville, La. 71446
Or drop it off at one of these Location
* GEICO
* Barksdale Federal Credit Union
* Sabine State Bank
Registration open now!!
____1 mile Fun Run/walk
____ 5K Run
____ 5K Super Squad
_________________________
Name
_________________________
Address
_________________________
Phone
T-shirt Size: S M L XL
In consideration of my entry being
accepted in the race, I waive any and all claims
for myself, my heirs, and assigns against all run co-sponsors, the AUSA and Fort Polk or any subdivision, its or their representatives, successors and assigns for injury or loss which may result from participation in this event.
__________________________________________________________
Signature Date
__________________________________________________________
Signature of parent or Guardian if under 18 years of age. Date
Sponsored By:
Byrd Regional Hospital
Barksdale Federal Credit Union
Merchant & Farmers Bank
Alford Motors
American Moving & Storage, Inc.
GEICO Insurance
Alexandria International Airport
Sabine State Bank
WTA (Warrior Training Alliance)
AECOM
Picerne Military Housing
Physical Therapy Service of West Louisiana
First Command Financial Planning
City Savings & Trust Co.
The Vernon Bank
Fertitta Insurance Agency
Pioneer Financial Services
To enter fill out this from & mail to
P.O. Box 2570, Leesville, La. 71446
Or drop it off at one of these Location
* Geico
* Barksdale Federal Credit Union
* Sabine State Bank
____1 mile Fun Run/walk
____ 5K Run
____ 5K Super Squad
_________________________
Name
_________________________
Address
_________________________
Phone
T-shirt Size: S M L XL
In consideration of my entry being
accepted in the race, I waive any and all claims
for myself, my heirs, and assigns against all run co-sponsors, the AUSA and Fort Polk or any subdivision, its or their representatives, successors and assigns for injury or loss which may result from participation in this event.
__________________________________________________________
Signature Date
__________________________________________________________
Signature of parent or Guardian if under 18 years of age. Date
To enter fill out this from & mail to
P.O. Box 2570, Leesville, La. 71446
Or drop it off at one of these Location
* Geico
* Barksdale Federal Credit Union
* Sabine State Bank
____1 mile Fun Run/walk
____ 5K Run
____ 5K Super Squad
_________________________
Name
_________________________
Address
_________________________
Phone
T-shirt Size: S M L XL
In consideration of my entry being
accepted in the race, I waive any and all claims
for myself, my heirs, and assigns against all run co-sponsors, the AUSA and Fort Polk or any subdivision, its or their representatives, successors and assigns for injury or loss which may result from participation in this event.
__________________________________________________________
Signature Date
__________________________________________________________
Signature of parent or Guardian if under 18 years of age. Date
To enter fill out this from & mail to
P.O. Box 2570, Leesville, La. 71446
Or drop it off at one of these Location
* Geico
* Barksdale Federal Credit Union
* Sabine State Bank
____1 mile Fun Run/walk
____ 5K Run
____ 5K Super Squad
_________________________
Name
_________________________
Address
_________________________
Phone
T-shirt Size: S M L XL
In consideration of my entry being
accepted in the race, I waive any and all claims
for myself, my heirs, and assigns against all run co-sponsors, the AUSA and Fort Polk or any subdivision, its or their representatives, successors and assigns for injury or loss which may result from participation in this event.
__________________________________________________________
Signature Date
__________________________________________________________
Signature of parent or Guardian if under 18 years of age. Date
To enter fill out this from & mail to
P.O. Box 2570, Leesville, La. 71446
Or drop it off at one of these Location
* Geico
* Barksdale Federal Credit Union
* Sabine State Bank
____1 mile Fun Run/walk
____ 5K Run
____ 5K Super Squad
_________________________
Name
_________________________
Address
_________________________
Phone
T-shirt Size: S M L XL
In consideration of my entry being
accepted in the race, I waive any and all claims
for myself, my heirs, and assigns against all run co-sponsors, the AUSA and Fort Polk or any subdivision, its or their representatives, successors and assigns for injury or loss which may result from participation in this event.
__________________________________________________________
Signature Date
__________________________________________________________
Signature of parent or Guardian if under 18 years of age. Date
To enter fill out this from & mail to
P.O. Box 2570, Leesville, La. 71446
Or drop it off at one of these Location
* Geico
* Barksdale Federal Credit Union
* Sabine State Bank
____1 mile Fun Run/walk
____ 5K Run
____ 5K Super Squad
_________________________
Name
_________________________
Address
_________________________
Phone
T-shirt Size: S M L XL
In consideration of my entry being
accepted in the race, I waive any and all claims
for myself, my heirs, and assigns against all run co-sponsors, the AUSA and Fort Polk or any subdivision, its or their representatives, successors and assigns for injury or loss which may result from participation in this event.
__________________________________________________________
Signature Date
__________________________________________________________
Signature of parent or Guardian if under 18 years of age. Date
To enter fill out this from & mail to
P.O. Box 2570, Leesville, La. 71446
Or drop it off at one of these Location
* Geico
* Barksdale Federal Credit Union
* Sabine State Bank
____1 mile Fun Run/walk
____ 5K Run
____ 5K Super Squad
_________________________
Name
_________________________
Address
_________________________
Phone
T-shirt Size: S M L XL
In consideration of my entry being
accepted in the race, I waive any and all claims
for myself, my heirs, and assigns against all run co-sponsors, the AUSA and Fort Polk or any subdivision, its or their representatives, successors and assigns for injury or loss which may result from participation in this event.
__________________________________________________________
Signature Date
__________________________________________________________
Signature of parent or Guardian if under 18 years of age. Date
1 mile Fun Run/Walk
5K Run-Individual
5K Run- Super Squad
( 7-Person team)
male,female, or mix
Date May 3rd 2008
Time: 8 A.M.
Downtown Leesville in front of Post Office
Entry Fees:
* $10 individual per-registration
* $15 if day of the event
* $ 45 per super squad
* Entry fee includes free T-shirt
* With proof of AUSA membership $5.00 discount on all individual fees
Trophies for 1st, 2nd,& 3rd places
(male & female)
17 & under
18-34 and
35 & over age groups
To enter fill out this from & mail to
P.O. Box 2570, Leesville, La. 71446
Or drop it off at one of these Location
* GEICO
* Barksdale Federal Credit Union
* Sabine State Bank
Registration open now!!
____1 mile Fun Run/walk
____ 5K Run
____ 5K Super Squad
_________________________
Name
_________________________
Address
_________________________
Phone
T-shirt Size: S M L XL
In consideration of my entry being
accepted in the race, I waive any and all claims
for myself, my heirs, and assigns against all run co-sponsors, the AUSA and Fort Polk or any subdivision, its or their representatives, successors and assigns for injury or loss which may result from participation in this event.
__________________________________________________________
Signature Date
__________________________________________________________
Signature of parent or Guardian if under 18 years of age. Date
Sponsored By:
Byrd Regional Hospital
Barksdale Federal Credit Union
Merchant & Farmers Bank
Alford Motors
American Moving & Storage, Inc.
GEICO Insurance
Alexandria International Airport
Sabine State Bank
WTA (Warrior Training Alliance)
AECOM
Picerne Military Housing
Physical Therapy Service of West Louisiana
First Command Financial Planning
City Savings & Trust Co.
The Vernon Bank
Fertitta Insurance Agency
Pioneer Financial Services
To enter fill out this from & mail to
P.O. Box 2570, Leesville, La. 71446
Or drop it off at one of these Location
* Geico
* Barksdale Federal Credit Union
* Sabine State Bank
____1 mile Fun Run/walk
____ 5K Run
____ 5K Super Squad
_________________________
Name
_________________________
Address
_________________________
Phone
T-shirt Size: S M L XL
In consideration of my entry being
accepted in the race, I waive any and all claims
for myself, my heirs, and assigns against all run co-sponsors, the AUSA and Fort Polk or any subdivision, its or their representatives, successors and assigns for injury or loss which may result from participation in this event.
__________________________________________________________
Signature Date
__________________________________________________________
Signature of parent or Guardian if under 18 years of age. Date
To enter fill out this from & mail to
P.O. Box 2570, Leesville, La. 71446
Or drop it off at one of these Location
* Geico
* Barksdale Federal Credit Union
* Sabine State Bank
____1 mile Fun Run/walk
____ 5K Run
____ 5K Super Squad
_________________________
Name
_________________________
Address
_________________________
Phone
T-shirt Size: S M L XL
In consideration of my entry being
accepted in the race, I waive any and all claims
for myself, my heirs, and assigns against all run co-sponsors, the AUSA and Fort Polk or any subdivision, its or their representatives, successors and assigns for injury or loss which may result from participation in this event.
__________________________________________________________
Signature Date
__________________________________________________________
Signature of parent or Guardian if under 18 years of age. Date
To enter fill out this from & mail to
P.O. Box 2570, Leesville, La. 71446
Or drop it off at one of these Location
* Geico
* Barksdale Federal Credit Union
* Sabine State Bank
____1 mile Fun Run/walk
____ 5K Run
____ 5K Super Squad
_________________________
Name
_________________________
Address
_________________________
Phone
T-shirt Size: S M L XL
In consideration of my entry being
accepted in the race, I waive any and all claims
for myself, my heirs, and assigns against all run co-sponsors, the AUSA and Fort Polk or any subdivision, its or their representatives, successors and assigns for injury or loss which may result from participation in this event.
__________________________________________________________
Signature Date
__________________________________________________________
Signature of parent or Guardian if under 18 years of age. Date
To enter fill out this from & mail to
P.O. Box 2570, Leesville, La. 71446
Or drop it off at one of these Location
* Geico
* Barksdale Federal Credit Union
* Sabine State Bank
____1 mile Fun Run/walk
____ 5K Run
____ 5K Super Squad
_________________________
Name
_________________________
Address
_________________________
Phone
T-shirt Size: S M L XL
In consideration of my entry being
accepted in the race, I waive any and all claims
for myself, my heirs, and assigns against all run co-sponsors, the AUSA and Fort Polk or any subdivision, its or their representatives, successors and assigns for injury or loss which may result from participation in this event.
__________________________________________________________
Signature Date
__________________________________________________________
Signature of parent or Guardian if under 18 years of age. Date
To enter fill out this from & mail to
P.O. Box 2570, Leesville, La. 71446
Or drop it off at one of these Location
* Geico
* Barksdale Federal Credit Union
* Sabine State Bank
____1 mile Fun Run/walk
____ 5K Run
____ 5K Super Squad
_________________________
Name
_________________________
Address
_________________________
Phone
T-shirt Size: S M L XL
In consideration of my entry being
accepted in the race, I waive any and all claims
for myself, my heirs, and assigns against all run co-sponsors, the AUSA and Fort Polk or any subdivision, its or their representatives, successors and assigns for injury or loss which may result from participation in this event.
__________________________________________________________
Signature Date
__________________________________________________________
Signature of parent or Guardian if under 18 years of age. Date
To enter fill out this from & mail to
P.O. Box 2570, Leesville, La. 71446
Or drop it off at one of these Location
* Geico
* Barksdale Federal Credit Union
* Sabine State Bank
____1 mile Fun Run/walk
____ 5K Run
____ 5K Super Squad
_________________________
Name
_________________________
Address
_________________________
Phone
T-shirt Size: S M L XL
In consideration of my entry being
accepted in the race, I waive any and all claims
for myself, my heirs, and assigns against all run co-sponsors, the AUSA and Fort Polk or any subdivision, its or their representatives, successors and assigns for injury or loss which may result from participation in this event.
__________________________________________________________
Signature Date
__________________________________________________________
Signature of parent or Guardian if under 18 years of age. Date