Run with the Dogs - Frostbite 5K
January 9, 2010, 9:00 a.m.
Decatur, GA
OFFICIAL ENTRY FORM – PLEASE PRINT
Name: _______________________________________________________________________________
Street Address: ___________________________________________________________________________
City, State, Zip: ___________________________________________________________________________
Email: __________________________ M: ______ F: ______
Event (circle one): 5K City of Decatur Student or Teacher (circle one): yes.......no
T-shirt size (circle one): YOUTH: S......M.......L....... ADULT: ....S......M........L.......XL
Enclosed is my fee of ________________ Additional donation ___________
| Cost: $20 by 12/26/09. Late and race day registration will be $25. City of Decatur Students and Teachers: $15 by 12/26, $20 late or race day. |
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Waiver I know that running a road race is a potentially hazardous activity. I am in proper physical condition to complete this run/walk and assume all risks associated with my participation including, but not limited to, falls, contact with other participants, and the effects of the weather, including high heat and/or humidity, traffic, conditions of the road, all such risks being known and appreciated by me. I will not wear headsets or any device that restricts my hearing or other perception. In consideration of this entry, for myself and anyone entitled to act on my behalf, I waive and release all race officials, volunteers, sponsors, and any others associated with this event. Furthermore, I hereby grant the agents of this event permission to use photographs, videotapes, motion pictures, recordings or any other record of me in this event for legitimate purposes |
Signature of Participant ________________________________________________ Date _______
Signature of Parent/Guardian
____________________________________________ Date ________
(if participant is under 18)
Please make all checks payable and return completed registration form to:
DBABC, PO Box 3241, Decatur GA 30031-3241