5-Miler Race Registration-Wash DC ROCKS

WASHINGTON, DC CHAPTER OF THE ROCKS, INC. 5-MILER RACE & 2 MILE WALK SEPTEMBER 13, 2008 Burke Lake Park - Race Begins 8:30 a.m. REGISTRATION

REGISTRATION
Event:		5M Run 2M Fun Walk
Please check one:		Male Female
Age:
T-Shirt Size:		M L XL XXL
Name:
Street Address:
City:
State:
Zip:
Phone:
Fax:
E-mail:

ROTC Team Member:		Yes No Team Name:
Corporate Team Member:		Yes No Team Name:

PAYMENT AMOUNT
AMOUNT		(Member) $20 BY 9/5 --- $25 AFTER 9/5
		(Non-Member) $25 BY 9/5 --- $30 AFTER 9/5
		(Under Age 15) $15 by 9/5 --- $20 AFTER 9/5


DONATION
In addition to my registration, enclosed is a tax deductible donation of $

YOU MUST AGREE TO THE FOLLOWING WAIVER TO BE ADMITTED TO THE RACE Agree I acknowledge that running a road/cross country race is a potentially hazardous activity. I should not enter and run unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run/walk. I assume risks associated with running/walking in this event including, but not limited to: falls, contact with other participants, effect of the weather including high humidity, traffic and the condition of the road, all such risks being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of your accepting my entry, I for myself and anyone entitled to act on my behalf waive and release the sponsors of the ROCKS 5-Miler, RacePacket, Inc., PVA, USATF, and any other sponsors and their representatives and successors from all claims or liabilities of any kind arising out of my participating in this event even though liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I grant permission to all of the foregoing to use any photographs, motion picture, recording, or any other record of this event for any legitimate purpose. I realize that medical support for this race will consist of volunteer medical personnel prepared to administer first aid type assistance along the race course and at the finish line.

PAYMENT METHOD

If you agree with all of the information on this form, please press the "Submit" button below to take you to the PayPal button to submit your payment. Thank you. Cancellation Policy: Cancellations received by 5 p.m. on 9/5 will receive a refund. No-shows or cancellations received after 5 p.m. on 9/5 are responsible for full payment and will be charged.