National Association for Court Management
Fun Run/Walk Registration
July 14, 2015
Last name ...... First name ......
Address (street, city, state) ......
......
Guest of (if applicable)......
Attendee$20RunWalk T-Shirt ONLY ($15)
Male T-Shirt Size ______(S-XXL) Female T-Shirt Size ______(XS-XXL) (sizes run small)
(T-shirt is included in your registration for the Fun Run/Walk when you register by June 21. A few additional shirts will be available at the conference on a first-come/first-served basis.)
Guest $20 RunWalkT-Shirt ONLY ($15)
Male T-Shirt Size ______(S-XXL) Female T-Shirt Size ______(XS-XXL) (sizes run small)
(T-shirt is included in your registration for the Fun Run/Walk when you register by June 21. A few additional shirts will be available at the conference on a first-come/first-served basis.)
WAIVER
I know that participating in a road race is a potentially hazardous activity. I understand that I should not participate unless I am medically able and properly trained. I also acknowledge that there will be traffic on the course route and agree to abide by all pedestrian crossing rules and traffic regulations. I assume any and all other risks associated with participating in this event including, but not limited to, falls, contact with other participants, the effects of the weather, including high heat and/or humidity, and condition of the roads --all risks being known and appreciated by me. Knowing these facts, and in consideration of the payment of the entry fee or participation as a course volunteer, I hereby for myself, my heirs, executors, administrators or anyone else who might claim on my behalf, covenant not to sue, and to waive, release, and discharge the National Association for Court Management, including its board and members, the National Center for State Courts and all staff, race officials, volunteers, and any and all sponsors --including their agents, employees, assigns, or anyone acting on their behalf, from any and all claims or liability for death, personal injury or property damage of any kind or nature whatsoever arising out of or in the course of my participation in this event. This Release and Waiver extends to all claims of every kind or nature whatsoever, foreseen or unforeseen, known or unknown.
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DATESIGNATURE
Payment Method
Check $______made payable to National Association for Court Management (NACM)
Cash $______
Charge $______to: Amex MasterCard Visa
Card #: ______Exp. Date: Mo.______Yr. ______
Signature (required for all charge orders)______
Return to Conference Services: (757) 564-2002 (fax) or or
Mail to NACM, c/o Association Mgmt, 300 Newport Avenue, Williamsburg, VA 23185-4147