Supporting running in the metro Richmond area

Time: October 3, 2009 from 8:30am to 11am
Location: Greater West Point Family YMCA
Street: 3135 King William Ave
City/Town: West Point
Phone: 804-843-3300
Event Type: fundraiser, west, point, ymca, strong, communities
Organized By: Sean Cogan
Latest Activity: Sep 30, 2009
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REGISTRATION FORM
First Name: (please print) ___________________________________ Last Name: ____________________________________
Address: _________________________________________________________ Phone Number: ________________________
City: _______________________________________________________ State: ______________ Zip: ___________________
Email Address: ____________________________________________ Age: ________ Birthday (mm/dd/yy): ______________
T-shirt Size: (adult sizes) Small Medium Large X-Large
Gender: Male Female
8K __________ Fun Run (1 mile) ______ Tot Trot _______
8K participants Only: Crab Carnival T-Shirt (adult sizes): S M L XL XXL
Fee: _______ $30 8k
_______ $15 Fun Run
_______ $10 Tot Trot
I know that running a race is a potentially hazardous activity. I should not enter and run unless I am medically able and properly trained. I agree to abide by any decision of race officials relative to my ability to safely complete the run. I assume all risks associated with running this event including, but not limited to, falls, contact with other participants, the effects of the weather, including high heat or humidity, traffic and conditions of the road, all such risks being known and appreciated by me. I understand this is a road race and is not intended for individuals with headphones, baby joggers, baby stroller, dogs on leashes, skateboards, or skates and I will abide by these guidelines. 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 Peninsula Metropolitan YMCA, Town of West Point and County of King William, race officials, volunteers and all sponsors, their representatives and successors from claims or liabilities or any kind arising out of my participation in this event. I grant permission to all the forgoing to use any photographs, motion pictures, recordings or any other record of this event for any legitimate purpose.
Signature ________________________________________________________________________________________ Date ____________________________
Guardian if under 18 _______________________________________________________________________________ Date ____________________________
Waivers will be available the morning of the event.
Mail Completed Registration Form to:
Greater West Point Family YMCA
P.O.Box 1526
West Point, Virginia, 23181
Call (804) 843-3300 for more information.
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