REGISTRATION FORM

Centennial Jubilee Sunset Fun Run 18 August 2012

Registration No:_________ Fun Run Category: 5K Run - Ateneo to Ateneo Sunset Fun Run 2K Run - Grade S !oolers Sunset Fun Run 1K Run - Grade S !oolers Sunset Fun Run Printed Name Participant Status: Grade S !ool #ig! S !ool College Gend er "ost-Graduate Alu$ni%"arent Fa ult&%Sta''%Ad$in Age Signature

For Participants under 18 years, name of Parent/Guardian giving the consent

Signature o' "arent%Guardian

Release and

ai!er o" #ia$ility% Assumption o" Ris& and Indemnity Agreement

(n onsideration o' )arti i)ating in t!e Centennial Jubilee Fun Run *1K%2K%5K+, ( re)resent t!at ( understand t!e nature o' running e-ents and t!at ( a$ .uali'ied, in good !ealt!, and in )ro)er )!&si al ondition to )arti i)ate in su ! an a ti-it&/ ( a 0no1ledge and agree t!at, i' ( belie-e e-ent onditions are unsa'e, ( 1ill i$$ediatel& dis ontinue )arti i)ation in t!e a ti-it&/ Furt!er$ore, ( 1ill o$)l& 1it! instru tions as )ro-ided b& t!e Centennial Jubilee Fun Run organi2ers, ( 1ill 'ollo1 t!e stated route, and ( 1ill not e$bar0 until su))ort sta'' is in )la e and t!e Fun Run route is o''i iall& o)ened/ ( 'ull& understand and agree t!at running e-ents are in!erentl& dangerous a ti-ities t!at in-ol-e ris0s o' serious bodil& in3ur&, in luding )er$anent disabilit&, )aral&sis and deat!, 1!i ! $a& be aused b& $& o1n a tions, or ina tions, t!ose o' ot!ers )arti i)ating in t!e e-ent, t!e onditions in 1!i ! t!e e-ent ta0es )la e, or t!e negligen e o' t!e 4releasees5 na$ed belo1 or ot!er auses6 and t!at t!ere $a& be ot!er ris0s eit!er not 0no1n to $e or not readil& 'oreseeable at t!is ti$e6 and ( 'ull& a e)t and assu$e all su ! ris0s and all res)onsibilit& 'or losses, osts, and da$ages ( in ur as a result o' $& )arti i)ation in t!e a ti-it&/ ( !ereb& release, dis !arge, and o-enant 'or $&sel', $& !eirs, e7e utors and ad$inistrators, not to sue t!e Ateneo de 8a$boanga 9ni-ersit&, Grade S !ool "arents-:ea !ers Asso iation, -olunteers, ot!er )arti i)ants, additional s)onsors, ad-ertisers, and, i' a))li able, o1ners and lessors o' )re$ises on 1!i ! t!e a ti-it& ta0es )la e *ea ! onsidered one o' t!e 4R;<;AS;;S5 !erein+ 'ro$ an& and all liabilit&, lai$s, de$ands, losses, auses o' a tion or da$ages o' 1!ate-er 0ind or nature, arising 'ro$ or related in an& 1a& to $& )arti i)ation in t!e Fun Run aused or alleged to be aused in 1!ole or in )art b& t!e negligen e o' t!e 4releasees5 or ot!er auses, in luding negligent res ue o)erations/ ( 'urt!er agree t!at i', des)ite t!is release, 1ai-er o' liabilit&, and assu$)tion o' ris0, ( $a0e a lai$ against an& o' t!e 4releasees,5 ( 1ill inde$ni'&, sa-e, and !old !ar$less ea ! o' t!e 4releasees5 'ro$ an& loss, liabilit&, da$age or ost 1!i ! $a& be in urred as t!e result o' su ! lai$, in luding reasonable attorne&=s 'ees/

Registration Fee Slip

:o be 'illed u) b& t!e Registration in- !arge *Registrant=s Co)&+
Registration No:_______________ >ate_________________ :!is is to a 0no1ledge re ei)t o' ?ne #undred *"!) 100/00+ "esos 'ro$ ________________________________ as Registration Fee 'or t!e 5K 2K 1K Centennial 'u$ilee Fun Run on () August *+(* at ,:++ in t-e a"ternoon. :!e Registration 'ee is in lusi-e o' Certi'i ate o' "arti i)ation, Running @ib and drin0ing 1ater on si7 1ater stations stationed on t!e entire stret ! o' t!e 'un run route/ Please present this slip on the day of the fun run to claim your running bib.

"a&$ent Re ei-ed b&: _____________________________