Saturday, November 13, 2010 -- Saint Albans, WV / Saint Albans High School
Nick Caldwell 5K Run and 1 Mile Memory Walk
CONTACT: e-mail firstname.lastname@example.org or call (304)416-2502 or (304)722-3577
5K RUN fee: $15 until Oct. 30, 2010, $20 thereafter & on race day
1-Mile WALK: $5 until Oct. 30, 2010, $10 thereafter & on race day
Mail application with appropriate fee(s) to: (payable to Nick Caldwell Memorial Race)
Nick Caldwell Memorial Race
16 Red Oak Drive
Nitro, WV 25143
Age on Race Day (11/13/10):_______ Gender: M___ or F____
Event entered (check one): 5K Run____ or 1-Mile Walk____
Amount Enclosed: $___________________
5K Run T-shirt* Size: (check one): S___ / M____ / L____ / XL____ / XXL____
* First 100 Registered runners guaranteed a shirt.
(Parent/guardian must sign for entrants under 18)
General Release: I know that strenuous exercise is a potentially hazardous activity and that I should not enter this event 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 race. I assume all risks associated with participating in this even including, but not limited to, falls, contact with other participants, the effects of the weather, traffic, and the conditions of the road, 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 the race organizers, Kanawha County, and any and all of its employees, representatives, or agents, the City of Saint Albans and any and all of its employees, and all sponsors and their representatives and successors, from all claims and liabilities of any kind arising from my participation in this event, even though that liability may arise out of negligence or carelessness on the part of the person(s) named in this waiver.