| print in portrait format if possible
Friendship City 5K Official Entry Form Name: _______________________________________ Address:______________________________________ City, State, Zip:_________________________________ Phone:________________________________________ Sex:_____________Age on Race Day:____________ email:__________________________________________________________________________________ Race Division (check one only): 5K Run _________ 5K Walk_________ Entry Fee: (check only one) ________$15 Pre-registration with T-shirt ________$25 Family Pre-Registration (must mail in all applications together) T-shirts are an additional $5 each. List Sizes needed. _______$15 Race Day without T-shirt _______$20 Race Day with T-shirt while supplies last _______$35 Race Day Family Registration. T-shirts are an additional $5 each while supplies last. T-Shirt size: (circle one if applicable) S, M, L, XL Make checks payable to:
"City of Erlanger" WAIVER: In consideration of the acceptance of my entry, I hereby waive on behalf of my heirs, executors, and assigns, all claims of any nature arising from my participation in the Friendship City 5K and do hereby release the City of Erlanger, USATF, Running Time, LLC and all sponsors, workers, officials, and volunteers from any claim whatsoever arising from my participation in this event. I agree to abide by all the rules for participation and acknowledge that the Race Committee may refuse or return my entry at its discretion. I understand that the risks for such a run and have trained adequately in preparation. I have noted any relevant medical conditions on the back of this form. I permit the use of my name and picture participating in this event for publicity. ENTRY SIGNATURE:_____________________________________________Date: __________________ Parent's Signature (if under 18): ____________________________________Date: ___________________ Emergency Contact: __________________________________________Phone________________________ |