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Mountain Home Marathon Last Name _______________ First
Name ___________________ Date of Birth __/__/__ Age on
Race Day ______ M ___ F ___ Street ___________________________________________________ Town ___________________ State
________ Zip_______________ Email:_____________________________________________________ Half Kid’s Marathon_______ $5/ After Nov 3rd $15.00 (at high school track at 5K _____
$20/ after
Nov 3rd $30 with no extra charge for race day registration Circle adult Shirt
Size: Adult Small
Med Large Xtra-Lge X-Xtra-large
Youth Small Med
Large Gourmet Primo Pasta Dinner 5:30-7:00 Nov 16th at CLC Center
of 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 to: |