River Trail 15K Entry Form

The River Trail 15K North Little Rock, AR - Burns Park February 6, 2010 9:00 AM
ENTRY FORM - PLEASE PRINT	Grand Prix Website: www.ArkRRCA.com
Online Registration Available at: http://www.active.com/event_detail.cfm?event_id=1800899
Name: Last:	First:
Date of Birth:
Age on February 6, 2010:_____ (must be 10 by race date to enter)
Sex: M F
Address:
City, State, ZIP:
Shirt Size: ____ S ____ M ____ L ____ XL ____ No T-shirt ($5 off entry fee)
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 Arkansas RRCA, the RRCA, and all sponsors 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 Signature if under 18 years old:
Entry Fee: $20 preregistered, $25 day of race Ages 10-18: $10 preregistered, $15 day of race $5 off for No T-Shirt option Make checks payable to Arkansas RRCA and mail to: Arkansas RRCA c/o Brian Sieczkowski PO Box 1422 North Little Rock, AR 72115