Rock Run 8K Entry Form

Rock Run 8K Little Rock, AR Murray Park May 29, 2010 7:30 AM
ENTRY FORM - PLEASE PRINT	Grand Prix Website: www.ArkRRCA.com
Name: Last:	First:
Date of Birth:
Age on May 29, 2010:_____
Sex: M F
Address:
City, State, ZIP:
Email Address:
Shirt Size (T-shirts guaranteed to the first 300 registrants): ____ YM ____ YL ____ S ____ M ____ L ____ XL
Release: I know that running and volunteering to work in club races are potentially hazardous activities. I should not enter and run in this race 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 and volunteering to work in club races including, but not limited to falls, contact with other participants, the effects of the weather, including high heat and/or humidity, the conditions 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 accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release Easter Seals of Arkansas, the Arkansas RRCA, and all sponsors from all claims or liabilities of any kind arising out of my participation in the race and/or club activities even though 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, or any other record of this event for any legitimate purpose.
Signature:	Date:
Parent Signature if under 18 years old:
Entry Fee: $20 preregistered, $25 after May 19th Ages 18 and Under: $15 preregistered, $20 after May 19th Make checks payable to Easter Seals Arkansas and mail to: Easter Seals Arkansas 3920 Woodland Heights Road Little Rock, AR 72212