Mountain Home Marathon Nov, 15, 2008 Mountain Home High School 8 a.m. Rain or shine
Last Name ______________________________________ First Name ___________________ Date of Birth ____/____/____ Age on Race Day _________ M _____ F ______ Street ________________________________________________________________________ Town _________________________________________ State ________ Zip_______________ Email:_________________________________________________________________________ Marathon ________ $60 after Nov 1st $70 Nov 14th and 15th $80 Half Marathon _____ $45 after Nov 1st $55 Nov 14th and 15th $65 (shuttle to start line begins leaving from high school at 6:45 a.m.) 5K ______ $20 after Nov 1st $30 with no extra charge for race day registration All entrants and families are invited to a post race, potluck dinner provided by the local churches. Circle Shirt Size: Adult: S M L XL XXL Youth: S M L Gourmet Primo Pasta Dinner - 5:30-7:00 Nov 14th - Adults $10.00 Children $5.00 Number of Adults ______ Number of Children ______ Meatless preferred_____
Pasta dinner provided by Mary Jo and her daughter Jameeo Traver, a grad of the Seattle Culinary Institute. 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 the Mountain Home Marathon, City of Mountain Home, and all sponsors, their representatives and successors 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’s signature if minor) Mail application and payment to:
Mountain Home Marathon Laurie Kasinger 445 CR 1008 Mountain Home, AR 72653 |