Saturday, September 29, 2007 -- Davis, WV / Davis Fire Hall
Tour of Davis Run for it '07
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Name __________________________________________________________________________
Mailing Address_________________________________________________________________
City__________________________ State_______________________________________
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Age _______ Birth date: ____/____/____ T-Shirt size: S M L XL
Event you wish to participate in: _____2K _______5K
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(Enter the general area or TCEF Named Fund that you wish to support. If you are not sure, call the TCEF office.)
If you are participating as part of a team entry, what is the name of your team?
_________________________________________________________________________________
All event participants must sign this waiver of liability. If you are the parent/guardian of children under 18 entering the event, please provide their names on the waiver below.
I, ____________________________________________, acting for myself and (if applicable) as the legal parent or guardian of __________________________________________________ , hereby release event sponsors, organizers, volunteers and/ or any member of the BOD of TCEF from any claims for damages or injuries suffered as a result of my and/or my child's participation in this event and waive any claim that I or my child might have against the event sponsors, organizers or volunteers from damages arising out of, or in any way relating to my or my child's participation in this event. I hereby consent to and permit and accept the responsibility for emergency medical treatment in the event of injury or illness suffered by myself and /or my child. I grant TCEF the right to use and incorporate, in whole or part, photographs or videotape taken of myself and/or my children for use in TCEF materials and waive any right to royalties or other compensation related to use of those photographs or videos.
X___________________________________________________Date ________________________
Signature of Participant, or Parent/Guardian if participant is a minor, is required.