Entry Form

Your Complete Event Production Company

Please complete all fields of this entry form.
Then print out and send in with
registration fee.

First Name:

Last Name:

Mailing Address - Include Apt. # and/or C/O

City:

State:

Zip Code:

Day Phone:

Birthdate:

Age:

M/F:

Shirt Size M / L / XL:

Event:

ACCIDENT WAIVER AND RELEASE OF LIABILITY

I acknowledge that this athletic event is an extreme test of a person's physical and mental limits and carries with it the potential for death, serious injury and property loss. The risks include but are not limited to, those caused by terrain, facilities, temperature, weather, condition of athletes, equipment, vehicular traffic, actions of other people including but not limited to participants, volunteers, spectators, coaches, event  officials, and event monitors, and/or producers of the event, and lack of hydration. These risks are not inherent to athletics, but are also present for volunteers. I hereby assume all of the risks of participating &/or volunteering for this event. I realize that liability may result from negligence or carelessness on the part of persons or entities being released, from dangerous or defective equipment or property owned or controlled by them or because of their possible liability without fault.  I certify that I am physically fit, have sufficiently trained for participation in the event and have not been advised otherwise by a qualified medical person.  I acknowledge that this Accident Waiver and Release of Liability form will be used by the event holders, sponsors and organizers of the event in which I may participate and that it will govern my actions and responsibilities at said event.
In consideration of my application and permitting me to participate in this event, I hereby take action  for myself, my executors, administrators, heirs, next of kin, successors and assign as follows (A) Waive, Release and Discharge from any and all liability for my death, disability, personal injury, property damage, property theft or actions of any kind which may hereafter  occur to me including y traveling to and from this event, THE FOLLOWING ENTITIES OR PERSONS.  RUNNING MASTERS, their directors, officers, employees, volunteers, representatives and agents, the event holders, event sponsors, event volunteers; (B) indemnify and hold harmless the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this event whether caused by the negligence of releases or otherwise. I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident and/or illness during this event. I understand that at this event or related activities, I may be photographed.  I agree to allow my photo, video or film likeness to be used for any legitimate purpose by the event holders, producers, sponsors organizers and assigns. The Accident Waiver and Release of Liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.

I hereby certify that I have read this document and I understand it's content.

 

  

  Signature (Parents signature if under 18)                                                                  Date

Print out this page - Make sure all blanks are filled in, including the event selection. BE SURE TO SIGN THE ENTRY FORM. Entry forms may not be sent in after the early registration postmarked date.  You may also print out this form and bring it on Race Day.

Make check payable to the specific event or as specified (i.e. “SWPCA” or “Valley of the Sun 5K” or “St. Patrick's Day 3 Miler”)
Send to; Running Masters, P.O. Box 27602, Tempe, AZ 85285

 


 

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