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Registration for the 2012 3rd Annual 5k Run/1 Mile Walk/1 Mile Fun Run

Please fill out the form below and submit it or print out a copy of the downloadable form and mail it along with payment to: River Green Run, 1600 River Park Blvd #202, Woodstock GA 30118

First Name:
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Last Name:
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Address:
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City:
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State:
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Zip:
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Phone:
E-mail: *
Gender
Age on Race Day:
Participation:
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Adult T-Shirt Size:
Kid T-Shirt Size:

WAIVER: In Consideration of acceptance of this entry, I am voluntarily participating in the Event with full knowledge of the inherent risks, hazards, and dangers involved and hereby assume and accept any and all risks of injury, paralysis, or death, and agree to abide by all River Green Run rules, regulations and guidelines. I, for myself, my heirs, successors, executors, and subrogors, hereby knowingly and intentionally waive and release, indemnify, and hold harmless the River Green Run or any of their officers, agents, affiliates, employees, contractors, sponsors, or volunteers, from and against any and all claims, actions, causes of action, liabilities, suits, expenses (including reasonable attorney's fees) and negligence or any kind or nature, whether foreseen or unforeseen, arising directly or indirectly out of any damage, loss, injury, paralysis, or death results from the negligence or other acts however caused by or contributed to by the River Green Run and all related entities named above, or from some other case. I, for myself, my heirs, my successors, executors, and subrogors, further agree to not to sue the River Green Run, their officers, agents, affiliates, employees, contractors, sponsors, or volunteers, as a result of any injury, paralysis or death suffered in connection with my participation in the Event. I attest that I am of the age of 18 years or older.

Participant Signature :
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Date:
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Participant/Guardian Signature:
Date:
(if participant is under 18 years of age)
* Required Fields