2012 Winter Winds Road Races 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 - Winter
Name:
(first)_________________________(last)_____________________________
Male p Female p
Address:____________________________________________________________
City:_________________________ State:_________
Zip code:___________
Telephone:____________________ Age on
Race Day:________ Birthdate:___________
Please check if
appropriate: HTC
Member p
Select T-Shirt Size (adult
sizes): Sp
Mp
Lp
XLp
Youth Mediump
Youth Largep
Select Race Distance: 2 milep 4
milep Fun
runp
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 Clubs of America (RRCA), 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 if the event is canceled
for any reason that all entry fees are non-refundable and this entry is
non-transferable.
Signature:________________________________________________________
Date:______________
Parent/Guardian if under age 19
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