RACE
APPLICATION Completion required.
Name-First ______________________________________________________________
Name-Last
______________________________________________________________
Address________________________________________________________________
City ______________________________________ State
________________________
Zip ______________________Phone________________________________________
Age (on race
day)_________________________________________________________
Circle Gender M
F
Date of Birth ___ - ___ - ___
Circle T-Shirt
Size XS S
M L XL
Circle Race Marathon
Half Marathon 5K Club/Group Affiliation
______________
Email Address _________________________________________________________
ENTRY FEES Non Refundable
*Event
Postmarked by 11-30-2009
|
After
12-01-2009
|
Marathon
|
$65.00
|
$75.00
|
Half
Marathon
|
$55.00
|
$65.00
|
5K
|
$30.00
|
$40.00
|
Students
18 and under photo copy ID for $10.00 discount
*Pre-Registration Guaranteed a T-shirt. Present
Student I.D. for discount � Parking
fee $5.00
*Children 9 and under free with paid parent or
legal guardian.
*Race Day Registration same as "After
12-01-2009" fees.
Liability Waiver for the Diamond Valley Lake
Marathon, Half Marathon, and 5K
In consideration of the acceptance of this entry in said
marathon, Half Marathon and 5K races to be held on January 23,
2010, at Diamond Valley Lake, Hemet, California, we, the
undersigned participant and (if participant is under 18 years of age)
parent or guardian, intending to be legally bound, do hereby for
ourselves, our heirs, executors and administrators, waive, release and
forever discharge any and all rights or claims for damages which we, or
either of us, may have or which hereafter accrue to us, or either of us,
against any and all persons, organizations and legal entities affiliated
with said race and, more particularly, the officials of the Diamond
Valley Lake Marathons, Habitat for Humanity, Metropolitan Water District
of Southern California, Reserve Management Committee and Member agencies
of the Riverside County Multi-Species Reserve, Urban Parks
Consessionaire, the City of Hemet, the County of Riverside, together with
their representative officers, agents, representatives, employees,
successors, assigns and/or sponsors, for any and all damages which may be
sustained or suffered by us in connection with or entry in, and /or
arising out of our traveling to, participation in and returning from said
race. I/we hereby agree to release to the race promoter full and
exclusive rights to record my performance in said race on film,
videotape, or still photography for use without compensation. I/we
understand that this is an arduous athletic event and herby certify that
I am properly conditioned to participate. All fees are nonrefundable.
Participant/Parent Signature___________________________________Date_____________
Make checks payable to : Habitat for Humanity Mail completed
form and fee to Habitat for Humanity, DVLM Post Office Box 1574, San
Jacinto, CA 92581-1574 Your cancelled check is your confirmation of
registration.
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