MARDI GRAS 5K Trail Run
February 25, 2012 * 9:00 am CST
Dothan, Alabama
Registration & Waiver Form
LOCATION: Westgate Park Trail. Register at Beauchamp Field across from the Tennis Center. Registration starts at 8 a.m. No pre-registration.
Entry Fee: $10. (no
shirts) Note: Proceeds from this event will benefit the
Dothan Area Botanical Gardens Plant Sale.
Awards: Overall
male/female, Masters, Grand Masters and 3 deep in standard 5 year age groups and
to first
three male & female walkers.
I know that running a road 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. I assume all risks associated with running in this event including, but not limited to, falls; contact with other participants; the effects of weather, including high heat and/or humidity; traffic; and the conditions 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 Dothan Runners Club, the City of Dothan, and all race sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in the 2012 MARDI GRAS 5K TRAIL RUN.
Name: Address:
City:State: Zip: Phone:
Age: (on 2/25/12) Date of Birth:
Email:
Select One:
Select Sex
Signature _____________________________________Date________________
(Parent or guardian must sign if entrant is under 18 years of age)
Race Day Registration Only. For more information call LARRY DYKES (334) 792-6021
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