Please complete ALL information below. Thanks! |
Full Name of Primary Participant**:
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Address**:
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City**:
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State**:
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Zip**:
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Phone**:
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Email**:
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Age of Primary Participant**:
Gender of Primary Participant**:
Male
Female |
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Shirt Color **:
Bright Neon Yellow
Sleeve Length **:
Short Sleeve
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Shirt Size**:
Adult S
Adult M
Adult LG
Adult XL
Adult XXL ( $2.00 extra )
Youth S
Youth M
Youth LG
Shirt Type **:
50/50 Cotton
Dri-Fit
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Need to sign up the entire family?
Please register them below.
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| Will there be a 2nd participant**?
Yes
No
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Full Name**:
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Age**:
Gender**:
Male
Female |
Shirt Color**:
Bright Neon Yellow
Sleeve Length **:
Short Sleeve
|
Shirt Size**:
Adult S
Adult M
Adult LG
Adult XL
Adult XXL ( $2.00 extra )
Youth S
Youth M
Youth LG
Shirt Type **:
50/50 Cotton
Dri-Fit
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| Participant #3: |
Full Name**:
|
Age**:
Gender**:
Male
Female |
Shirt Color**:
Bright Neon Yellow
Sleeve Length **:
Short Sleeve
|
Shirt Size**:
Adult S
Adult M
Adult LG
Adult XL
Adult XXL ( $2.00 extra )
Youth S
Youth M
Youth LG
Shirt Type **:
50/50 Cotton
Dri-Fit
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| Participant #4: |
Full Name**:
|
Age**:
Gender**:
Male
Female |
Shirt Color**:
Bright Neon Yellow
Sleeve Length **:
Short Sleeve
|
Shirt Size**:
Adult S
Adult M
Adult LG
Adult XL
Adult XXL ( $2.00 extra )
Youth S
Youth M
Youth LG
Shirt Type **:
50/50 Cotton
Dri-Fit
|
| Participant #5: |
Full Name**:
|
Age**:
Gender**:
Male
Female |
Shirt Color**:
Bright Neon Yellow
Sleeve Length **:
Short Sleeve
|
Shirt Size**:
Adult S
Adult M
Adult LG
Adult XL
Adult XXL ( $2.00 extra )
Youth S
Youth M
Youth LG
Shirt Type **:
50/50 Cotton
Dri-Fit
|
| Participant #6: |
Full Name**:
|
Age**:
Gender**:
Male
Female |
Shirt Color**:
Bright Neon Yellow
Sleeve Length **:
Short Sleeve
|
Shirt Size**:
Adult S
Adult M
Adult LG
Adult XL
Adult XXL ( $2.00 extra )
Youth S
Youth M
Youth LG
Shirt Type **:
50/50 Cotton
Dri-Fit
|
Waiver of Liability |
I know that running/walking a road and off-road event is a potentially hazardous activity. I should not run/walk unless I am medically able and properly trained. I agree to abide by any decision of the race officials. I assume all risks associated with running/walking in this event, including, but not limited to: falls, contact with other participants, effects of the weather, traffic, and conditions of the road and trail. Having read this waiver and knowing these facts, and in consideration of acceptance of my entry, I waive and release the Run/Walk for Ransom, all sponsors and representatives from all claims and liabilities of any kind arising from my participation in this event, even though such liability arises from negligence or carelessness on the part of persons name in this waiver. I grant permission to all foregoing to use any photographs, motion pictures, recordings (race times) or any other record of this event for any legitimate purpose.
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