Home for the Children Benifit Run
30 km trail run
May 17, 2008 7:00 AM Start
Name (please print) ______________________________________
Phone # ___________________________________
Address _________________________________________________________________________________
City ________________________________ State _________________ Zip code ____________________
** E-mail address: _____________________________________________________
Liability Waiver
I hereby certify that I (or my child if I am signing as parent/guardian) intend to participate in "Home for the Children Benefit Run". I am aware that participating in an event such as this is a potentially hazardous activity and that I (or my child) is medically fit to participate and will have sufficiently trained for the event prior to participation. I (or my child) agree to abide by the rules and decisions of any event officials and hereby assume all risks associated with my (or my child's) participation in the event and any associated activities. I understand that risks to such participation include but are not limited to falls, contact with participants, effects of weather such as heat, humidity, or trail conditions. intending to be legally bound, I (and my child) and anyone entitled to act on my (or our) behalf (s) hereby waive any and all claims whatsoever against and fully release, "Home for the Children Benefit Run Run" and Bluff Creek Ranch, all property owners and leased property owners, the race day volunteers, any and all race vendors and sponsors, event promoters, and their representatives and successors, from all claims, damages, or liability of any kind arising from my (or my child's) participation in the event. I grant full permission to any and all of the foregoing to use my name, or photographs, video tapes, other recordings, or any record of my participation in this event, without obligation or liability to me. I consent to any hospital care medical or surgical diagnosis or treatment to be rendered to me (or my child) as a result of any injuries that may arise from my participation in the event. I also understand and agree that I am solely responsible for any applicable charges for such medical services. If any provision or any part of this agreement is held to be legally unenforceable for any reason the remainder of this agreement is fully enforceable.
PARTICIPANT SIGNATURE __________________________________________ Date __________________
Parent or Guardian Signature (if under 18) _____________________________________________________________
Registration Fee $40.00
Make check out to: Home for the Children Mail to: Box 110 Warda TX 78960
Packet pick up the day before the race and race day at the ranch house.
for more info visit www.bcrwarda.com or e-mail us at bcrwarda@gmail.com or call 979-242-5894
* entry fee is tax deductible
** e-maill address optional, it will be recorded in our database.
