THE FIRST ANNUAL EMMETT HANNES MEMORIAL 5k
PRESENTED BY THEROTARY CLUB OF GIDDINGS
SATURDAY, MARCH 3, 2012 @ 9:00 a.m.
You can walk or run the 3.1 mile course. Prizes will awarded to top 3 males and females in the following age groups; runners & walkers 10 & under; 11 -15, 16-21, 22-29, 30-34, 35-39, 40-44, 45-49, 50-60, over 60
First Name: Last Name:
Date of Birth: Sex:
Address:
Race Day Emergency Contact Name #
Email:
T-shirt size (ys, ym. Yl, s, m, l or xl)
$25 until February 14, 2012 (t-shirt guaranteed); $30 after February 14th (t-shirt while supplies last)
Waiver Statement: By indicating your acceptance, you understand, agree, warrant and covenant as follows: I, the person submitting this entry (and my child if I’m signing as a parent or guardian) agree to abide by the rules and decisions of any event officials, and assume all risks associated with the event and any associated event or activities, including but not limited to falls, contact with other participants, effects of the weather or traffic, road conditions, all such risks being known and appreciated. I (and my child if I’m signing as a parent or guardian) and anyone entitled to act on my (our) behalf(s), assume all risks associated with participation, and waive any and all claims and fully release, the Rotary Club of Giddings, the City of Giddings and each of their employees or members, and all race day volunteers, event promoters, sponsors, their representatives and successors (collectively referred to as “Released Parties”), from all claims, damages, or liability of any kind arising from my (or my child’s) participation in this event. I hereby release, waive, discharge, covenant not to sue and agree to indemnify, hold harmless and defend for any and all purposes the Released Parties from any and all liabilities, damages and claims, demands, or injuries, including death, that may be sustained by me resulting from or arising out my participation in the Emmett Hannes Memorial Fun Run, INCLUDING ANY DAMAGES, CLAIMS, DEMANDS, OR INJURIES, INCLUDING DEATH, CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF OTHER ACT OR OMISSION OF THE RELEASED PARTIES, OR BY A PRE-EXISTING DEFECT. I grant full permission to any and all of the foregoing to use my (and my child’s) name or photograph, without obligation or liability to me (and my child). I also understand that entry fees are nonrefundable. T-shirt sizes are not guaranteed. I have read this agreement carefully, and understand it, and certify my agreement by my signature below. I understand and agree that this Waiver and Release is binding on my heirs and assigns.
Signature:
Date: