5th Annual 5K & Kids Run
Race day is Saturday, December 12, 2015 at Ellen Trout Zoo, Lufkin, TX. Awards presented to the top male and female finisher and top three finishing males and females in each age group. Packet pickup is Thursday December 10, 2015 from 5-8 pm at Orange Leaf & race morning starting at 7:00 a.m. Entry fees will increase by $5 the day of the race.
Walkers are welcome!
Saturday December 12, 20145Race Day Schedule:
Ellen Trout Zoo7:00 – 7:50 a.m.Packet pickup & late registration
402 Zoo Circle8:00 a.m. Kids Fun Run Starts (ages 4 – 12)
Lufkin, TX 759048:30 a.m.5 K begins
OFFICIAL ENTRY FORM: ***YOU MUST COMPLETE THE WAIVER ON THE BACK**
(May also register at
Name:______
Address:______
City:______State:______Zip:______
Age on Race Day:______Circle: MaleFemale
Email:______
Telephone:______
Emergency Contact and Phone:______
______$20 Kids Fun Run ages 4-12 ______$30 5K
T-Shirt Size: (available while supplies last)
Child:SMLAdult:SMLXLXXL
Make Checks Payable to:
Lufkin Community Partners
P. O. Box 153341
Lufkin, TX 75915
All proceeds benefit Lufkin Community Partners and the Rainbow Room
Lufkin Community Partners is a 501 © (3) non-profit organization;
Contributions are tax deductible according to IRS guidelines and limitations.
PARTICIPATION AGREEMENT, ASSUMPTION OF RISK, RELEASE AND WAIVER OF LIABILITY
PLEASE READ THIS AGREEMENT CAREFULLY
It is a legal contract and affects any rights you may have if you are injured or otherwise suffer damages while participating the Reindeer Run 5K & Kids Run sponsored by Lufkin Community Partners on December 12, 2015.
Inherent Risks and Dangers: As with most sports, this activity involves a number of inherent risks, including but not limited to tripping and falling, contact with other participants or spectators, the effects of weather, and trail/path/road conditions. Because the Reindeer Run 5K & Kids Run is run on trails/paths/roads, there are hazards such as possible potholes, rocks or other debris on the paths that may post a hazard. All participants need to be prepared to avoid tripping, falling or contact with obstacles. By choosing to participate, you are acknowledging your awareness and assumption of all risks associated with your participation.
Image/Voice Permission: Photographs or video/audio recordings may be taken of you during this activity. Unless you request otherwise, this Participation Agreement will be considered permission for Lufkin Community Partners to photograph, film, audio/video tape, record and/or televise your image for use in any publications or promotional materials, in any medium now known or developed in the future without any restrictions. If you object to Lufkin community Partnersusing your image or voice in this manner, please notify them, in writing, upon submission of the Agreement.
Health Condition of the Participant: You are certifying that you are medically and physically fit to compete in this event safely. By Signing this Participation Agreement, you agree:
That you have the physical fitness and ability to participate safely in the specified activity. In addition, you will participate in the specified activitywithin your ability and skill level.
To inform the program leader of any medication, ailment, condition, or injury that may affect your performance in the activity.
That you must supply your own health insurance and will bear all financial responsibility for any medical treatment arising from participation in the Reindeer Run 5K & Kids Run.
ASSUMPTION OF RISK, RELEASE AND WAIVER OF LIABILITY – PLEASE READ THIS CAREFULLY
It affects any rights you may have if you are injured or other wise suffer damages while participating in the Reindeer Run 5K & Kids Fun Run on December 12, 2015, sponsored by Lufkin Community Partners.
I, ______(participant) HEREBY RELEASE FROM LIABILITY, WAIVE, DISCHARGE AND COVENATNT NOT TO SUE Lufkin Community Partners, City of Lufkin, Ellen Trout Zoo, and any of the officers, servants, agents and employees of the above-mentioned entities (hereinafter referred to as RELEASEES) for any liability, claim and/or cause of action arising out of or related to any loss, damage or injury, including death, that occurs as a result of my participation in the above-described activities.
I agree to indemnify and hold harmless the RELEASEES whether injury is caused by my negligence, the negligence of the RELEASEES or the negligence of any third party. I further agree that this Release and Waiver of Liability shall bind the members of my family and spouse, if I am alive, and my heirs, assigns and personal representatives, if I am deceased, and shall be deemed as a RELEASE, WAIVER, DISCHARGE AND COVENANT NOT TO SUE the above-named RELEASEES. I hereby further agree that this Release and Waiver of Liability shall be construed in accordance with the laws of the State of Texas.
BY SIGNING THIS RELEASE AND WAIVER OF LIABLITLY, I STATE THAT I HAVE READ AND UNDERSTAND THE CONDITIONS SET FORTH IN THIS RELEASE AND THAT I AGREE TO ALL CONDITIONS SET FORTH HEREIN, AND THAT I SIGN THIS VOLUNTARILY.
Participant Name (please print)______Date ______
Participant Signature______
Signature of Parent or Guardian (if Participant is under age 18) ______