December 16, 2007 - February 3, 2008 -- Charleston, WV / Kanawha City Community Center
2007-2008 Winter Series Runs and Walks
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Mail with payment to: Charleston Parks & Recreation, 200 Baker Lane, Charleston, WV 25302
Waiver: I, the undersigned, waive and release myself, my heirs, executors, and administrators, any and all rights and claims for damages, demands, and any other actions whatsoever, which I may have against all participating sponsors and supporters and The City of Charleston, arising out of my participation in this event, including and all injuries, including death suffered me as a result of my participation in this event. I consider myself adequately trained for the completion of this event. Should I suffer an injury or illness, I authorize officials of this event to use their discretion to have me medically treated and transported to a medical facility. I also authorize the sponsors to use any photographs or video taken of me to be used in any promotional materials.
Signature:_____________________________________________________________
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Parent/ Guardian Signature Required Under 18 years of Age
Date: ____________________________________________________