Age Group__________ Elite________ Team___________ Clydesdale__________ Athena___________ (Athena - women 160+ lbs | clydesdale- 200+ pounds | Age group -most choose this option)WAIVER. I am properly trained and enter this race totally at my own risk and hereby waive all claims that I or my heirs may have against all sponsors, race directors and all others associated with this race, for any injuries or problems I may sustain, regardless of any negligence. I am totally responsible for my safety and any injury I may suffer.. Further, I hereby grant full permission to any and all of the foregoing to use my name, likeness and voice, as well as any photographs, videotape, motion pictures, recordings and any other record of this event in which I may appear for any legitimate purpose including broadcast of the event, the reuse in any media of this broadcast and in advertising and promotion.
Last Name First Name Age on Sex |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__| |__|__| |__| Race Day M/F Mailing address (include apt. # and c/o) |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__| City and State Zip/Postal Code |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__| |__|__|__|__|__|__| Birth date Area Code Telephone |___|___|___| |__|__|__| |__|__|__|-|__|__|__|__| Mo Day Yr Team Partners(if team)__|__|__|__|__|__|__|__|__|__|__|__|__|__| Team Partners(if team)__|__|__|__|__|__|__|__|__|__|__|__|__|__| E-Mail Address |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__| T-Shirt Size |__| Small |__| Medium |__| Large |__| X-Large
Signature (by parent or guardian if
participant is under 18) ___________________________________________________