27th Annual Critter Run 5K
July 28, 2012 * 6:00 pm CDT
Registration & Waiver Form
I know that running a road race is a potentially
hazardous activity. I should not enter and run 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 run. 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/or 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 entitled to
act on my behalf, waive and release the Dothan Runners Club, the City of Dothan,
and all race sponsors, their representatives and successors from all claims or
liabilities of any kind arising out of my participation in
the 2011 CRITTER RUN 5K.
Name:
Select Sex
Age: (on 7/28/12)
Address: Date of Birth
City: State: Zip: Phone:
E-Mail Address: :
Pre-register for preferred size. We do not guarantee all
sizes will be available on race day. This year we are offering choice of
tank top or t-shirt for pre-registered runners
only. On race day runners will have a choice as long as they are available.
Pre-registration closes on 7/17/2012.
Select
Shirt Size:
Circle One: Tank
T-shirt
Circle One: Run
Walk
Signature _________________________________________________________Date_____________
(Parent or guardian must sign if entrant is under 18 years of age)
Entry fee is $20 with a Tank Top or a T-shirt. Mail by 7/17 to reserve a shirt. Shirt not guaranteed to late entries or on race day. The no-shirt option is $15.
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to return to the 26th Annual Critter Run 5K Information Form