| 2006
KFRX Mayor's Run Entry
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| Name: |
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| Street: |
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| City: |
State:
ZIP:
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| Birthday: |
// Phone (optional): |
| Age: (raceday) |
Sex:
M F |
| School: |
School:
Current Grade: |
| Shirt: |
Child T-Shirt Size:
10-12 14-16
Adult T-Shirt
Size:
S M
L XL |
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PLEASE
READ WAIVER THEN SIGN AND DATE BELOW |
I know that running a road race is a potentially
hazardous activity. I should not enter and run 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 in this event including but not limited to:
falls, contact with other participants, the effects of
the weather including high heat and/or humidity, traffic
and the condition of the road, as such risks being known
and appreciated by me. Having read this waiver and
knowing these facts and in consideration of Lincoln Track Club accepting my entry, I for myself and anyone entitled
to act on my behalf, waive and release the Lincoln Track
Club, the City of Lincoln, all sponsors, their
representatives and successors from claims or liabilities
of any kind arising out of my participation in this event
though that liability may arise out of negligence or
carelessness on the part of the persons named in this
waiver. Further,
I hereby grant full permission to any and all of the foregoing to
use photographs, videotapes, motion pictures, and recordings of my
child, or any other record of this event, for any legitimate
purpose. I agree that an adult may accompany my child during
the run.
Signature: ________________________________________________
Date_____________________
Signature of parent or guardian:
_______________________________________________ |
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