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Run
On!'s
2009 Dash Down Greenville |
Bib Number  |
FIRST NAME:
_____________________LAST NAME: ___________________
AGE (03/14/09): _________ DATE OF BIRTH: _____________ SEX ________
ADDRESS:
_____________________________________________________
CITY: ________________________ STATE: _____ ZIP: _________________
E-MAIL: _______________________________________________________
DAY
PHONE:_________________________________________
PERSONAL CHIP #:
_______________________________
PACKET PICKUP LOCATION 3/11 - 3/13:
____ Dallas ____ Coppell ____ Richardson ____
McKinney ____ Race Day
T-SHIRT SIZE: __ S __
M __ L __ XL
To be eligible for awards you must wear a chip.
ENTRY FEES:
NO REFUNDS!!
____ $20 - Postmarded by March 4
____ $25 - Registration after March 4
____ $30 - Race Day Registration
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MAIL THIS FORM TO:
Run On!/St. Paddy's Day Dash
4950 Keller Springs #240
Addison, TX 75001 |
Make
Checks Payable to Texas Race Management
Registration by mail or in person can be made ONLY by cash or check |
WAIVER:
Entry invalid if not signed. In consideration of the acceptance of
this registration entry, I, the undersigned, assume full and complete responsibility for
any injury or accident which may occur to me during the event or while I am on the
premises of the event. I hereby release and hold harmless Run On!, Racing systems,
or any of the sponsors, promoters and all other persons and entities associated with the
event or their agents or employees or otherwise. I will not enter and participate
unless medically able and properly trained. I also know that although police
protection will be provided, there may be traffic on the course route. I assume the
risk associated with this event, including but not limited to falls, contact with other
participants, the effects of weather, and the conditions of the road. Fees are
non-refundable. I am responsible for the return of my ChampionChip which must be
surrendered at the finish area to avoid a lost chip fee. T-shirt size is not
guaranteed. I have read the foregoing and certify my agreement by this signature,
and my parent's or guardian's if under age 18.
___________________________________________________
___________________________
SIGNATURE
DATE
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