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Run for Ronald

Run for Ronald

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Published by jbingham92

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Published by: jbingham92 on Jan 17, 2011
Copyright:Attribution Non-commercial

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01/17/2011

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www.run4ronald.wikispaces.comJbingham92@gmail.com
 When: April 23, 2011 9:00am start timeWhere: City Hall Dallas, GA 129 East Memorial DriveDallas, GA 30132Registration Mail-In accepted through April 10
th
 
Run4Ronald 5K Run/Walk Registration Form  Saturday, April 23, 2011
Return forms and payment to: Run4Ronald 194 Princeton Dr. Dallas GA 30157
Name: _______________________________ Gender: M F Age on Race Day: _______Address: ___________________________________________________________________
Street City State Zip
Email: _________________________________ Phone: ____________________________
 
 
5K Adult Registration
($
25.00 registration fee)
 
 
 
T
eam Registration
(
$
35.00 registration fee
)
 
 
 
5K Child Registration
(
ages 6-15,
$
15.00 registration fee)
 
 
5K Child Registration
(
age 5 and under are free)
 
Payment Information:
I would like to pay by
(
circle one): CASH CHECK Please make checks out to: Run4Ronald 5k Association
Liability Waiver must be signed to participate in the Run4Ronald 5K Run/Walk 
I recognize that running a road race is a potentially hazardous activity. I have read the race flyer and am familiar with the course, procedures, and rules. I should not enter and run unless I am medically able and properly trained. I agree to abide by any decision of arace officials relative to my ability to safely complete the run. I assume all risks associated with running in this event including, but notlimited to: falls, contact with other participants, the effects of the weather, including cold, snow, and/or ice, high heat and/or humidity,traffic and the conditions of the road, all such risks being known and appreciated by me. Having read this waiver and knowing these factsand in consideration of your accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release the organizersof the Run4Ronald 5K Run/Walk, its directors, officers, staff, and volunteers, the city of Dallas, GA and its employees and all sponsors,their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event even though thatliability may arise out of negligence or carelessness on the part of the persons named in this waiver. Further, I grant permission to all of the foregoing to use any photographs, motion pictures, recordings or any other record of this event for any legitimate purpose. For runners safety, I understand that headsets, bicycles, scooters, and roller blades are prohibited. Strollers and dogs
(
on a short leash) areallowed.
I ALSO UNDERS
T
AND
TH
A
T
 
TH
ERE ARE NO REFUNDS FOR
TH
IS EVEN
T.
 
Signature of Participant: _____________________________________________Parent/Guardian Signature (
if under 18
): ___________________________________Date:__________________________

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