ST. PATRICK'S DAY 2010 REGISTRATION FORM

Please Fill Out One Entry Form Per Participant, Thank You!
 
 

Last Name

First Name

Team Name

 


 

 

Street

City

State       &    Zip

 

 

          /

Email

Phone

Date of Birth & Age

 

(      )        

               

7K & 1 Mile:
Preferred Shirt Size

Wee Folks:
Preferred Shirt Size

Gender

Small    Medium    Large    XLarge

Youth Medium  Youth Large

M         F


T-Shirt Guaranteed to:  First 700 7K or 1 Mile Entries & First 200 Wee Folk Entries

I will participate in: (please mark your event) 

    Run of Luck 7K: (please circle division)      Run        Walk         RaceWalker
                                Wheelchair   Handcycle   Visually Impaired   Ambulatory/Les Autres

         
    1 Mile Shamrock Shuffle 

    Wee Folks Kids Dash

ALL PARTICIPANTS MUST SIGN RACE WAIVER:

St. Patrick's Day Run of Luck and all Sponsors Waiver: I know that running or walking a road race is a potentially hazardous activity.
I should not participate unless I am medically able and properly trained. I also know that, although police protection will be provided,
there will be traffic on the course route. I assume the risk of running into traffic, I also assume any and all other risks associated with
running in this event including but not limited to falls, contact with other participants, and effects of the weather and the condition of
the roads, all such risks being and appreciated by me know thing these facts, and in consideration of your accepting my entry, I hereby
for myself, my heirs executors, administrators or anyone who might claim in my behalf, covenant not to sue, and waiver release and
discharge all sponsors, the State of Indiana, City of Evansville, Vanderburgh County and race officials and volunteers, any and all claims
of liability for death, personal injury or property damage of any kind or nature whatsoever arising out of, or in the course of my
participation in this event. This release and waiver extends to all claims of every kind of nature whatsoever, for reasons foreseen or
unforeseen, known or unknown. The under-signed waiver grants full permission to all sponsors and/or agents by them to use any
photographs, videotapes, motion pictures, recordings or any other record of this event for any purposes. Application for minors will be
accepted only with parent's signature.



___________________________________            ___________________________________
                 Participant Signature                                  Parent/Guardian Signature if Participant is under 18






MAKE ALL CHECKS PAYABLE:    RUN OF LUCK 7K

EVENT FEES ARE NON-REFUNDABLE

PLEASE MAIL ENTRIES TO:  

RUN OF LUCK 7K, 8949 VALLEY VIEW DRIVE, EVANSVILLE, IN 47711
 

 

  

  

    *TO PRINT ON 1 PAGE HIGHLIGHT FROM ST. PATRICK'S DAY FORM TO END OF WAIVER*
       NO WORRIES, FORM WILL NOT PRINT WITH A GREEN BACKGROUND.

**To receive registration form as PDF document send request to LeeAnnGee@aol.com
 

 

 

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