Last Gasp 5K Trail Run

December 27, 2008 * 9:00 am CDT
Registration & Waiver Form
ENTRY FEE:  $10.00 on Race Day from 8:00-8:50 A.M.

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 2005 Last Gasp  5K Trail Run.

Name: Address:

City:State: Zip: Phone:

Age: (on 12/27/08)Date of Birth:

Select One: Run Walk                   Select Sex Male Female

Signature _____________________________________Date________________
(Parent or guardian must sign if entrant is under 18 years of age)

Make checks payable to DOTHAN RUNNERS and mail to: Dothan Runners, PO Box 887, Dothan, AL 36302. No entry accepted without required fee. No refunds.  All entries must be signed.  For more information call LARRY DYKES (334) 792-6021

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Gasp 5K Trail Run Information Form