RESOLUTION SOLUTION
5K RUN/WALK
REGISTRATION FORM
TUESDAY, JANUARY 1, 2008
9:00 a.m.
Last Name First Name Age on Sex
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Jan 1 M/F
Mailing address (include apt. # and c/o)
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City and State Zip/Postal Code
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Birth date Area Code Telephone
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Mo Day Yr
E-Mail Address
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Shirt size S|__| M|__| L|__| XL|__|
WAIVER. Knowingly and at my own risk I do hereby apply to enter an athletic
contest. I hereby agree that I release and discharge Vacation Sports, and all other parties associated with the Resolution Solution 5k run/walk from all claims, demands, injuries, damages, actions or causes of action from all acts of active or passive negligence on the part of
such corporations, organizations, clubs, their servants, agents or employees, and hereby assume all the risks associated with my participation in the event. 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.
Signature
(by parent or guardian if
participant is under 18) ___________________________________________________
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