KOHEN'S 4 MILE MONKEY RUN

April 1 at 9 a.m.
STARTS & ENDS AT KOHENíS PARK
3138 HWY 321 N, WARD   (501) 765-0135 

 

 

  

REGISTRATION IS $20.00 PER PERSON, YOU WILL BE PROMPTED TO PAY WHEN YOU SUBMIT THE REGISTRATION. THE DEADLINE TO GET A SHIRT HAS PASSED AND WE CANNOT GET MORE. I understand that this event is a potentially hazardous activity and voluntarily assume all responsibility for the risk of any injury or accident which may occur during my participation. To the fullest extent of the law I, for myself, my next of kin, my heirs, administrators and executors hereby release and hold harmless and covenant not to file suit against Kohenís Park, Kohenís Park Foundation or Kohenís Park L.L.C. In submitting this form, I certify that I am in good physical condition and am solely responsible for my personal health, safety and personal property and that of my participating minors.  

Primary Contact Name:   Primary Contact Phone:  

Primary Contact Email

Participant Information:

Name:   Date of Birth:   Shirt Size:

Name:   Date of Birth:   Shirt Size:

Name:   Date of Birth:   Shirt Size:

Name:   Date of Birth:   Shirt Size:

Name:   Date of Birth:   Shirt Size:

Name:   Date of Birth:   Shirt Size:

Name:   Date of Birth:   Shirt Size:

Name:   Date of Birth:   Shirt Size:

Name:   Date of Birth:   Shirt Size:

Name:   Date of Birth:   Shirt Size:

Name:   Date of Birth:   Shirt Size:

Name:   Date of Birth:   Shirt Size:

Name:   Date of Birth:   Shirt Size:

Name:   Date of Birth:   Shirt Size:

Name:   Date of Birth:   Shirt Size:

Name:   Date of Birth:   Shirt Size: