Rodeo Fun Run Registration Form Saturday August 6th, 2011
Name_______________________________________________________________________________________ Email Address________________________________________________________________________________ Address_____________________________________________________________________________________ City____________________________________ State__________________ Zip__________________________ Age__________Sex__________ Shirt Size: Check One Youth Small_ Youth Medium_ Youth Large_
Adult Small Adult Medium Adult Large Adult XL
Registration form must be postmarked by
July 18th, 2011 to be guaranteed FREE t-shirt
2-mile Run/Walk 5-mile Run $25 – 14 and older $15 – 14 and under Make checks payable to Sidney Community Schools
Emergency contact name______________________________________________________________________ Emergency contact phone number______________________________________________________________ Send registration forms to Peter Johnson P.O. Box 670 Sidney, IA 51652 For more information: email@example.com or (402)917-3874 Waiver: I know that running is a hazardous activity. I should not run unless I am medically able and properly trained. I agree to abide by all race officials’ decisions 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, weather (including high heat and/or humidity), traffic, road conditions, all such risks being known and appreciated by me. Having read this waiver, knowing these facts and in consideration of your accepting this form, I, for myself, my heirs, and personal representative, waiver all rights and release to Sidney Community Schools, the City of Sidney, all race sponsors, their agents, representatives, successors, and assigns from any and all liability for injuries or damages suffered by me arising out of travelling to, participating in, or returning from the race. I grant permission to the Rodeo Fun Run to use any photographs, motion pictures, or any record of this event for any purpose. Race Directors reserve the right to cancel the event in case of severe weather.
Athlete’s signature____________________________________________________________________________ Date________________________________________________________________________________________