Run On! Running Class Registration Form

NAME: ___________________________________________________   

ADDRESS: _____________________________________________________

CITY: ________________________ STATE: _____ ZIP: _________________

PHONE (HM): ________________________ (WK) ______________________

AGE: _________ DATE OF BIRTH: _______________  SEX _____________

E-MAIL: _______________________________________________________

CURRENT EXERCISE PROGRAM: ______________________________________________________________
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LOCATION: __ Dallas   __ Coppell    __ McKinney __ Richardson   __Early Bird 101,201 Location
                   __ Early Bird Speed Location

T-SHIRT SIZE:    ___ Sm         ___Med        ___Lg         ___XLg        ___XXLg

PAYMENT BY: __ Cash  __Check (to RunOn!) __Visa __MasterCard  __ Discover __American Express
Program Fees are not refundable.  Race entries are not included.

WAIVER: I know that running and participating in this program is potentially hazardous.  I should not enter and run in this program unless I am medically and properly trained.  I agree to abide by any decision of a program official relative to my ability to safely complete this program.  I assume all risks associated with running and training in this program including, but not limited to falls, contact with other participants, effects of the weather including high heat and humidity, the condition of the road and traffic on the course, all such risks being known and appreciated by me.  Having read this waiver and knowing these facts, and in consideration of your acceptance off my entry, I for myself or anyone entitled to act on my behalf, waive and release RUN ON!,  all sponsors, and any individual or group associated with this program from all claims and liabilities of any kind arising out of my participation in this program even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver.  I grant permission to all the foregoing to use any photographs, motion pictures, recordings, verbal or written statements, or any other record of the program for any legitimate use.

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