Running For Life 10K TRAIL RUN /1 Mile Fun Run/Walk 2015 REGISTRATION FORM

June 20, 2015/Standing Rock, Steamboat, AZ (located on the Navajo Reservation in Northern Arizona)

Last Name / First Name / Male / Female
Event:
10K / 1 Mile / Birth Date (ex 04/19/1973) / Age on race day / Town of Residence
Mailing Address / City / State / Zip Code
Day Phone Number / Alternate Phone Number
Email / T-Shirt Size / Small / Medium / Large / X-Large / 2X-Large
Emergency Contact:
Name / Phone Number

Waiver (Please Read and Sign below – Waiver must be signed)

I understand that participation in the event “Running for Life 10k Trail Run or 1 Mile Fun Run/Walk” as a registered party should not participate unless medically able and properly trained. I understand that this event may be held over trails and over public roads and facilities open to the public during the event and upon which hazards are to be expected. Participation carries with it certain inherent risks that cannot be eliminated completely ranging from minor injuries to catastrophic injuries. I understand and agree that in consideration of being permitted to participate in the event I and any registered party, my heirs, personal representatives or assigns of mine or the registered party do hereby release, waive, and discharge not to sue or place claim of any kind against Running For Life, John Curley Jr, Elaina Vann, Standing Rock Parties, Steamboat or Standing Rock Community/Families or any other parties/sponsors affiliated with the event for any and all liability from any and all claims arising from participation in the event by myself or any registered party.By indicating my acceptance of this agreement and waiver, I am affirming that I have read and understand this agreement and waiver and fully understand its terms. I understand that I am giving up substantial rights, including the right to sue. I acknowledge that I am signing the agreement and waiver freely and voluntarily, and intend by my acceptance to give complete and unconditional release of all liability to the greatest extent allowed by law.
I hereby grant permission for photos of my participation in the event to be used on the and any other promotional items affiliated with Running for Life.
Signature of Participant: / Date
Signature of Parent or Guardian (if participant is under the age of 18) / Date