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Firecracker Fast 5K
July
4, 2009 --
7:30am -- Little Rock, AR
Online Registration |
Name:
Last:
First: |
Date of Birth:
Sex: M F
Age on 7/4/09: |
Address: |
City, State, Zip: |
Shirt Size: Adult
-- S
M L
XL XXL
|
Release:
I know that running and volunteering to work in club races are
potentially hazardous activities. I should not enter and run in this
race 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 and
volunteering to work in club races including, but not limited to falls,
contact with other participants, the effects of the weather, including
high heat and/or humidity, the conditions of the road and traffic on the
course, all such risks being known and appreciated by me. Having read
this waiver and knowing these facts, and in consideration of your
accepting my entry, I, for myself and anyone entitled to act on my
behalf, waive and release the Firecracker Fast 5K, Easy Runner, the City
of Little Rock, ArkansasRunner.Com and all sponsors, their representatives and successors
from all claims or liabilities of any kind arising out of my
participation in the race and/or club activities even though liability
may arise out of negligence or carelessness on the part of the persons
named in this waiver. I grant permission to all the foregoing to
use any photographs, motion pictures, recordings, or any other record of
this event for any legitimate purpose. |
Signature:
Date: |
Parent Signature if under 18 years:
Date: |
|
Make checks payable to Easy Runner
and mail to:
11525 Cantrell Road, Suite 102, Little Rock,
AR 72212
|
|
Fees: $25 pre-registered, $30 day of race
$10 for children 12 and under
For
information, call 501-221-0017 |
|
