Ready! Set! Run!
5K Run/Walk & 1 Mile Fun Run/Walk
|
|
A.
Registration
Information
Name_________________________________________
Age
(on race day) ________ Gender___________
Mailing
Address____________________________________
City___________________
State _____ Zip Code__________
Phone____________________________________________
E-mail____________________________________________
B. Shirt order.
Circle all that apply:
adult size /
Child size OR i
do Not want a SHirt
S
M L XL
XXL
C. Registration Fee. Circle one.
Dates
|
Without t-shirt
|
With t-shirt
|
5K Run/Walk
Postmarked by
March 11
|
$15 |
$18 |
5K Run/Walk
March 12 through
Race
day entry |
$20 |
$20 |
1Mile Fun Run/Walk
Postmarked by
March 11
|
$10 |
$13 |
1Mile Fun Run/Walk
March 12 through
Race day entry
|
$15 |
$15 |
I know that road race is
a potentially hazardous activity. I should not enter unless I am medically able
and properly trained. I agree to abide by any decision of a race official
relative to my ability to safely complete the run. I assume all risks
associated with running this event including, but not limited to, falls,
contact with other participants, the effects of the weather, including heat
and/or humidity, traffic and conditions of the road, and all such risks being
known and appreciated by myself. Having read this waiver, knowing these facts,
and in consideration of my entry being accepted, I, for myself and anyone
entitled to act on by behalf, waive and release the Holland ISD, all sponsors,
their representatives and successors from all claims or liabilities of any kind
arising out of my participation in this event even though that liability may
arise out of the negligence or carelessness on the part of the person(s) named
on this waiver.
Signature
________________________________ Date ________________
Parent/Guardian (if under
18)
Make
checks payable to: Holland ISD. All mail
must be postmarked by March 11, 2009.
Mail
to:
C/O