2010 Fund Run - 8K 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. See you on race
day. Good luck.
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Individual Entry Form - Fund Run - 8K
Name:
(first)_________________________(last)_____________________________
Male p
Female p
Address:____________________________________________________________
City:_________________________
State:_________ Zip code:___________
Telephone:____________________ Age on
4/3/10:________ Birthdate:____/____/____
mm/ dd /
yy
T-shirt size: S p M p Large p XL p
Please check if appropriate: HTC Member p
In addition to my $10 or $15 entry fee, I have included a $___________ donation to the HTC Scholarship Fund. (Optional)
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:______________
Parent/Guardian if under age 19
Mail application, entry fee and any Scholarship Fund donation to:
Tab
Barnett
307 Westchester Ave.
Huntsville, Al 35801
Make checks payable to The Fund Run.
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Fund Run 8K Information Page