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����� 1K����� Club/Group Affiliation
______________
Email Address _________________________________________________________
ENTRY FEES Non Refundable
*Event
|
Postmarked
By 2/28/2012
|
After
2/28/2012
|
Marathon
|
$65.00
|
$75.00
|
Half Marathon
|
$55.00
|
$65.00
|
5K
|
$30.00
|
$40.00
|
1K, Kid Run
|
$15.00
|
$15.00
|
Students
18 and under photo copy ID
for $10.00 discount (Kid Run Not Included)
*Pre-Registration Guaranteed a T-shirt. Present
Student I.D. for discount � Parking
fee $5.00 *Race Day *Same Day
Registration available
Liability Waiver for the Diamond Valley Lake
Marathon, Half Marathon, 5K, and 1K
In consideration of the acceptance of this entry in said
Marathon, Half Marathon, 5K, and 1K races to be held on April 9,
2011, 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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