27 th Annual Armadillo Stampede

1. Date: Saturday, May 1st, 2010 Start Time: 8 A.M. Downtown Leesville in front of U.S. Post Office Entry Fees: $10 individual per-registration $15 if day of the event $ 45 per super squad With proof of AUSA membership you will get a $5.00 discount on all individual fees Trophies for 1st, 2nd,& 3rd places (male & female) 17 & under 18-35 and 35 & over age groups Date May 1st 2010 Time: 8 A.M. 27th Annual Armadillo Stampede • 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 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 _________________________ Name _________________________ Address _________________________ Phone T-shirt Size: S M L XL - 1 mile Fun Run/Walk - 5K Run - Individual - 5K Run - Super Squad ( 7-Person team) male, female, or mix First 100 race registrants will receive a free t-shirt! ____1 mile Fun Run/walk ____ 5K Run - Individual ____ 5K Run - Super Squad First 100 race registrants will receive a free t-shirt!

2. 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 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 _________________________ Name _________________________ Address _________________________ Phone T-shirt Size: S M L XL ____1 mile Fun Run/walk ____ 5K Run - Individual ____ 5K Run - Super Squad First 100 race registrants will receive a free t-shirt! • 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 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 _________________________ Name _________________________ Address _________________________ Phone T-shirt Size: S M L XL ____1 mile Fun Run/walk ____ 5K Run - Individual ____ 5K Run - Super Squad First 100 race registrants will receive a free t-shirt! • 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 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 _________________________ Name _________________________ Address _________________________ Phone T-shirt Size: S M L XL ____1 mile Fun Run/walk ____ 5K Run - Individual ____ 5K Run - Super Squad First 100 race registrants will receive a free t-shirt!

3. 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 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 _________________________ Name _________________________ Address _________________________ Phone T-shirt Size: S M L XL ____1 mile Fun Run/walk ____ 5K Run - Individual ____ 5K Run - Super Squad First 100 race registrants will receive a free t-shirt! • 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 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 _________________________ Name _________________________ Address _________________________ Phone T-shirt Size: S M L XL ____1 mile Fun Run/walk ____ 5K Run - Individual ____ 5K Run - Super Squad First 100 race registrants will receive a free t-shirt! • 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 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 _________________________ Name _________________________ Address _________________________ Phone T-shirt Size: S M L XL ____1 mile Fun Run/walk ____ 5K Run - Individual ____ 5K Run - Super Squad First 100 race registrants will receive a free t-shirt!