2010 Pilgrim Chase 5K Trail Run Waiver

Each Participant must complete a 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 the 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 the consideration of you accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release  the Dothan Runner's 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 2010 PILGRIM CHASE 5K TRAIL RUN.
Fill out the form then print out your registration form.

Name:Address:

City: State:   Phone:Age:Sex: Female Male
                                                                                                 (Age on 11/27/10)

Select Race: Run Walk   ____  Walk ____  Email_______________________________________ 

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

  Entry fee is $10.  Race Day registration only.  Registration begins at Beauchamp Field at 8:00 AM.    Race starts at 9:00 AM.  Do not mail entry form.  Bring form to race or register race day. 

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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