River City 5K Run Race or 2Mile Fun Walk Registration Form
Saturday, July 24, 2010
Participant's Name:
___________________________________________________________
Address:_____________________________________________________________________
City: _________________________________ State: ___________ Zip:
_________________
Phone: _______________________________ Email:
_________________________________
Date of Birth: _______________________ Age
on Race Date:
________
Gender: ___Male ___Female
WAIVER. My participation in the River City Run/Walk is at
my own risk, I release and discharge all claims for damages, personal injury,
illness or death-including those which may be attributed to weather
conditions-which I have or may occur as a result of my participation in this
event. This release is intended to discharge volunteers, officials, employees,
race directors, sponsors, and all others associated with this event from any and
all liability arising out of or connected with my participation in this event.
Signature: _________________________________________ Date:
___________________
Parent/Guardian (under 18) Signature:__________________________ Date: ___________
[ ] FEE for 5KRun:
$17 (Before July 4, 2010;
$22 (After July
4, 2010)
[ ] FEE for 2 Mile Fun Walk: $10 (Before July 4,
2010 $16 (After July
4)
NYLON SPORT PACK GUARANTEED TO ALL PRE-REGISTRANTS!
Race Timer: Apple Raceberry Jam