2nd Annual Warrior Mud Run - Waccamaw High School Athletics
Transcription
2nd Annual Warrior Mud Run - Waccamaw High School Athletics
2nd Annual Warrior Mud Run Saturday, June 20, 2015 Waccamaw High School, Pawleys Island, SC www.waccamawathletics.com/warriorrun All proceeds benefit the WHS Athletic Booster Club APPLICATION PAWLEYS ISLAND, SC PRICING Individual Team of 4 Kids 10-13 4/28-5/31 $40 $140 $25 6/1-6/19 $50 $180 $25 Race Day $60 $220 $25 JUNE 20, 2015 START TIME 9:00 a.m. All Individuals 9:30 a.m. Male Teams PACKET PICKUP 10:00 a.m. Co-Ed Teams Friday, June 19..........4:00-7:00 pm 10:30 a.m. Female Teams Moe’s BBQ - 1287 Ocean Hwy Entry Fee Non Refundable 11:00 a.m. Kids Race Pawleys Island Saturday, June 20.....7:30-8:30 am ON-LINE REGISTRATION active.com (registrant pays active.com fee) Start/Finish Line or MAIL CHECK AND ENTRY FORM TO SHIRTS Waccamaw High School Athletic Booster Club Shirts are guaranteed to early registration participants entry forms and P.O. Box 1491, Pawleys Island, SC 29585 fees received by midnight May 31, 2015. email: [email protected] Every finishing participant guaranteed a medal if registered by May 31 Warrior Run Entry Form Check One o Individual o Kids Race o TEAM/Male o TEAM/Co-Ed o TEAM/Female Individual or Kids Name______________________________________________________________ Sex o Male o Female Birth Date__________________ Address __________________________________________________________________________________________________________ City _______________________________________________________________________ State_________ Zip Code_________________ Phone_____________________________________ Email__________________________________________________________________ Unisex Shirt Size circle one Adult S M L XL XXL Youth M L Team Name______________________________________________________________________________________________________ Team Captain/Teammate 1__________________________________________ Sex o Male o Female Birth Date__________________ (The Team Captain will be responsible for receiving all correspondence for their team) Address __________________________________________________________________________________________________________ City _______________________________________________________________________ State_________ Zip Code_________________ Phone_____________________________________ Email__________________________________________________________________ Unisex Shirt Size circle one Adult S M L XL XXL Youth M L Teammate 2 _______________________________________________________Sex o Male o Female Birth Date__________________ Email__________________________________________________________________ Unisex Shirt Size circle one Adult S M L XL XXL Youth M L Teammate 3_______________________________________________________ Sex o Male o Female Birth Date__________________ Email__________________________________________________________________ Unisex Shirt Size circle one Adult S M L XL XXL Youth M L Teammate 4_______________________________________________________ Sex o Male o Female Birth Date__________________ Email__________________________________________________________________ Unisex Shirt Size circle one Adult S M L XL XXL Youth M L ASSUMPTION OF RISKS, RELEASE OF liability AND PHOTO RELEASE: In consideration if being allowed to participate, I myself and any minor children for whom I am a parent, legal guardian, or otherwise, and for my heirs, and assigns, hereby acknowledge and assume all risks involved in participating in this event and release the sponsors, race workers, officials and volunteers of the race from any and all liability arising from injury, illness and damages (including death) I, or my family and /or group participants for whom I am a representative may suffer as a result of participation in such an event. I understand that this activity may create physical stress resulting in possible harmful effects and I agree that I am, and my family and/or group participants whom I am a representative are, physically fit and sufficiently trained to participate in the event. I understand that the entry fee is non-refundable. I give permission for free use of my, or my family and/or group participants for whom I am a representative, name and picture in any broadcast or written accounts of the event. If race officials deem medical attention is necessary due to injury or illness, I, Or my family or group participants for whom I am a representative consent to be removed from the course and treated by medical personnel of their direction I have read this assumption of risk and release of liability and understand that by signing this document, I, and my family and/or group participants for whom I am a representative, are waiving valuable legal rights I, or we, have in conjunction with this event. I hereby voluntarily grant the Georgetown County School District, Waccamaw High School and the Waccamaw High School Athletic Booster Club, its agents or assigns, permission to use any and all photographs of me for purposes of reproduction in any form, but not limited or advertising, illustration, newspaper stories, television or radio broadcast or other publication. Each member will be required to sign release waiver at packet pickup.
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