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Online Entry Confirmation Receipt:
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Confirmation Number:
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20723-40661-105604-10152009-074536
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Event:
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Salvando Vidas Una Milla a la Vez a Beneficio de la Sociedad de Leucemia y Linfoma
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Race/ Category:
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5K Run
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Name:
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JOSE JULIAN ORTIZ HERNANDEZ
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Event Day Age:
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31
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Gender:
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F
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Registration Date:
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10/15/2009
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Registration Method:
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ONLINE
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Registration Status:
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REGISTERED
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Bib:
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Registration :
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Registration (Qty: 1)
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Authorization Letter
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I, JOSE JULIAN ORTIZ HERNANDEZ, hereby authorize __________________________________ to act on my behalf to pick up my packet for the Salvando Vidas Una Milla a la Vez a Beneficio de la Sociedad de Leucemia y Linfoma '09. Any and all acts carried out on my behalf shall have the same affect as acts of my own.
____________________________
Name: JOSE JULIAN ORTIZ HERNANDEZ
Date: 9/9/10
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