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Winter Race Series Entry 2004-2005
First Name __________________ Last Name_______________________
Address _________________________________________
City _____________________________ Zip ___________
Phone (_____)_________________________
Age ________ (as of December 5, 2004)
Male .........Female (circle one)
HCR members: $10 for series or $3 per race
NON HCR members: $25 for the series or $7 per race
Winter Race Series Fee $ ___________
HCR Runners Club Membership Enclosed (link
to membership form)
New - Renewal (optional) $____________ $15.00/year
Total money enclosed $ ____________
Return this section to:
HCR's Club Winter Race Series
P.O.Box 1511
Yakima, Washington
98907
RELEASE. I know that running a road race is potentially
hazardous activity. I should not enter and run unless I am medically able
and property 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 in this event including,
but not limited to: falls, contact with other participants, 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. 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 Hard Core Runners Club, its officers and agents,
the American Association of Running Clubs, the City and County of Yakima
and any and all participating race sponsors and the
director, officers, employees and agents of such parties, their representatives
and successors from all claims or liabilities of any kind arising out
of my participation in this event even though that liability may arise
out of negligence or carelessness on the part of the persons named in
this waiver. I understand that bicycles, skateboards, baby joggers, roller
skates or inline skates, animals and radio headsets are not allowed in
the race and I will abide by this guideline.
_________________________________ __________________
Participants Signature ........................................Date
_________________________________ __________________
Parent or guardian if participant is under 18 .................Date
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