2011 Monte Sano 15K Entry Form Page
Please
clip out the entry form and mail with the appropriate fees. Please print
legibly and complete fully.
Incomplete or illegible applications may not be accepted.
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Please note: For the safety of
all runners and due to liability insurance requirements the following are not
allowed during the race: strollers, baby joggers, skateboards, bicycles, animals,
roller blades, headphones, iPods, MP3 players, unauthorized vehicles, unentered runners, etc. Anyone violating this
policy will be DISQUALIFIED (not posting in results, no awards, not
refunds). Your cooperation is greatly
appreciated. |
Individual
Entry Form - Monte Sano 15K
Name: (first)_________________________(last)_____________________________
Male p
Female p
Address:____________________________________________________________
City:_________________________
State:_________ Zip code:___________
Phone:(____)________________ Age on
Race Day:________ Birthdate:___________
Email:__________________________________
Select T-Shirt Size (adult
sizes):
XSp Sp Mp
Lp
XLp
2XLp
Huntsville Track Club Member?
Yesp Nop
o By checking the box to the left I agree that my
participation in this event requires that I will not participate with roller blades,
baby joggers, skateboards, animals, headphones, iPods, MP3 players or anything
which the race director deems dangerous to myself or other participants and
that the race director may disqualify me from this event for a violation of
said policy.
Race Waiver: I, individually, (and/or as parent, and/or guardian of the
named minor) for and in consideration of acceptance of this entry in the
aforementioned event, do hereby release, remise, waive, and forever discharge
the Road Runners Club of America, Huntsville Track Club and any and all other
supporting groups of this said racing event, together with all their officers,
agents, officials and employees, from any and all liability, claims, demands,
actions, or causes of action whatsoever arising out of, or relating to any
injury, illness, loss, or damage, including death, relating to participation in
the aforesaid event. I further state I
am in proper physical condition to participate in this event. In addition, I
agree that my participation in this event requires that I will not participate
with roller blades, baby joggers, skateboards, animals, headphones, or anything
which the race director deems dangerous to myself or
other participants and that the race director may remove me from this event for
a violation of said policy. I further
grant permission to this race and the organization conducting the race and/or
agents authorized by them to use any photographs, videotapes, motion picture,
recordings and any other record of this event for any purpose. I also agree that all entry fees are
non-refundable and that this entry is non-transferable.
Signature:________________________________________________________
Date:______________
Must be signed by
parent or guardian if under age 19
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Mail application to:
Mike O'Melia
Hampton Cove, AL 35763
Make checks
payable to the