Entry Form
Turlock Summer 5k Series
www.centralvalleyroadracing.moonfruit.com
Registration postmark by 5/16/09 for May race; 6/13/09 for June race; 7/11/09 for July race; and 8/17/09 for August race. $25 for Single race and $75 for series. After 5/24/08 for May race; 6/20/09 for June race; 7/18/09 for July race; and 8/22/09 for August race. $30 for Single race and $75 for series. May 30st Race Day is the last day to register for full series
[ ] Check box to enter without a shirt @ reduced price of $18.00. Five dollar late fee skilled occurred for late entries. NO LATE FEES APPLIED IF YOU REGISTER AT RUNNER’S FEET 405 E. MAIN ST, TURLOCK
Indicate Race: May / June / July / August / Series
Email______________________________________________________
sex: M / F Date of Birth:____/____/_____ Age on Race Day________
LastFirst
Name:____________________________ Name:_____________________________
Address________________________________________________________________
City_____________________________ State_______ Zip Code___________________
T-Shirt S / M / L/ XL Phone(______)__________________________
Team/ Club__________________________________
signature:___________________________________________ Date________________
All entrants must sign a waiver. Parent/Guardian if under 18
In consideration of your acceptance of this race entry, I, for myself, my heirs, executors, administrators, and assigns, forever waive, release and discharge any and all rights, demands, claims for damages and cause of suit or action, known or unknown that I may have against CVRR.Mgt, Lawrence Blaylock, and any and all participating race contributors, sponsors, and supports and the directors officers, employees and agents of such parties for any and all injuries from my participation in said race. I attest and verify that I have full knowledge of the risk involved in this race, that I assume those risk, that I will assume and pay my own medical and emergency expenses in the event of an accident, illness or other incapacity regardless of whether I have authorized such expense and that I am physically fit and sufficiently trained to participate in this race. I grant permission to any and all of the forgoing to free use of my name, voice and /or likeness in any broadcast, advertising and or promotion release related to this event or future CVRR.Mgt event.
