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2001 Race with an Angel Registration Form

 

Age: _______           Birthdate (D/M/Y)  ____/_____/_____

 

Run/Walk:      o Run 5K o   Walk 5K     o   Mile Fun Run

Gender:           o   Male          o   Female

 

Name: (Last) _________________   (First)  ____________

Address:     _____________________________________________

Phone:    (______) _______- _________   E-Mail:_______________

School (If student) _________________

 

Shirt Size:         oXXL         oXL      oL    oM    

 

Fees:       5k Run/Walk:                                                       Mile Fun Run

o $12   Registration before 10/1/00         o   $8 Registrations on or after 10/1/00

o $10    Students before 10/1/00                o   $10 Registrations on or after 10/1/00

o $10  FARC                

o   $15 Registrations on or after 10/1/00 

Please make checks payable to: "The Lu McGowan Race"

Mail this form with registration fee to:    

Mary Anne McFerren

6904 Vanderbilt Avenue, Richmond, VA 23226

 

Lu McGowan Race Waiver:  I know that participating in this event, either as a runner, walker, or volunteer, is a potentially hazardous activity.  I should not enter and participate unless I am medically able and properly trained.  I agree to abide by any decision of a race official relative to my ability to safely complete the event.  I assume all risks associated with running in this event, including, but not limited to falls, contact with other participants, the effects of weather, including high heat and humidity, traffic and the conditions of the road, all such risks being known and appreciated by me.  Having read this waiver and knowing these facts and in consideration of your accepting my entry, I, for myself, and anyone acting on my behalf,      waive and release the Lu McGowan Race Committee and the Fall Festival Committee, and all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event even though the liability may arise out of negligence or carelessness on the part of the persons named in this waiver.


 Signature:___________________ (Parent's signature if under 18 years old)     Date: ________

 

 

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