2016 Zombie Registration Form.cdr

ouabache state park & bluffton parks department
present
Zombie
5k fun run
at ouabache
state park
The Park After Dark
Saturday, Oct. 29, 2016 5:00 p.m.
$20 PRE-REGISTRATION / $25 RACE DAY REGISTRATION
HUMAN RUNNERS: Un-dead runners get a 90 second head start with flags that represent
life. Make it to the finish line with at least one flag or become one of the walking dead!
AWARDS: 1st, 2nd 3rd male/female (based on time) , Most Creatively Dressed
ZOMBIE RUNNERS: Try to steal human runners’ flags. Come dressed as a Zombie
or come early to visit the Zombie Zone to be transformed into the perfect and scariest zombie!
AWARDS: 1st, 2nd, 3rd male/female (based on number of flags captured, Zombie Beauty
Contest (male/female)
ZOMBIE RUN SCHEDULE
3:00 - 4:45 ..... Check In and Race Day Registration Open
3:00 - 6:00 ...... Zombie Zone Open
5:00:00............. Human Runner Start
5:01:30............. Zombie Start
6:00 ................. Awards & Prizes
STAY FOR THE EVENING
OUBACHE STATE PARK
FALL FESTIVAL EVENTS
Trick or Treating, Hayride, Story Telling, & More!
----------------------------REGISTRATION (PLEASE PRINT) -----------------------------------------NAME: ____________________________________________________________________________
ADDRESS: ________________________________________________________________________
EMAIL: ____________________________________________________________________________
PHONE: ______________________
AGE (on race day): ______
CIRCLE T-SHIRT SIZE:
MEDIUM
Run As A (Circle One):
SMALL
Human
or
Zombie
LARGE
XL
SEX: ___ Male
2XL
___ Female
Don’t miss this opportunity to become a one of the walking dead. Come in your best costume and makeup and chase down
the living! If you need help getting into Zombie mode, come early and visit our Park After Dark Zombie Zone and have our
make up artists help you find your inner Zombie.
What does a Zombie Do?
1. Zombies walk, run, and crawl.Your goal is to scare, more then chase, but always reach for a runner’s flag.
2. Your goal is to capture the flags of the runners as they run by - so reach or chase!
3. Zombies DO NOT TALK! They grunt, growl, and moan.
4. You are allowed to stay in groups - in open areas we encourage it. These are called Zombie Nests.
5. Only take 1 flag per runner.
6. Absolutely NO intentional physical contact. Accidental contact may occur as you reach for a flag. Do you best not to touch the a runner.
Zombies
Zombie Rules:
1. You must be 14 years old or older to be on the course without a parent or legal guardian.
2. You must never make physical contact with the living in attempt to stall them or capture their flags.
3. No pets allowed.
4. No weapons of any kind (toys or real).
5. Only take 1 flag per runner.
6. Talking to other Zombies is not permitted - Zombies do not talk. Zombies moan, scream and growl!
Human Rules:
1. You must never make physical contact with Zombies in attempt to push them out of the way or even knocking their arms out of
the way. If they get close enough to grab your flag, it’s your fault for being to slow!
2. You must be 14 years old or older to race on the course without a parent or legal guardian.
3. No weapons allowed (toys or real).
4. Run fast, Zombies hate fast food.
5. You will have 3 flags, when (if) your 3rd flag gets taken, you become Zombified. Take a minute to stomp your feet and cry,
then get over it and make your way to the finish line to celebrate. Come back next year to redeem yourself.
6. No picking up flags off the ground.
7. Screaming is allowed, but only for wimps.
WAIVER AND RELEASE OF LIABILITY
I acknowledge that this athletic event is an extreme test of a person's physical and mental limits and
carries with it the potential for death, serious injury and/or property loss. The risks include, but are not limited to, those caused by terrain, facilities, temperature,
weather, lack of hydration, condition of athletes, equipment, vehicular traffic, and actions of other people including, but not limited to, participants, volunteers,
spectators, coaches, event officials, event monitors, and/or producers of the event. These risks are not only inherent to the athletes , but are also present for
volunteers. I hereby assume all of the risks of participating in and/or volunteering at this event. I certify that I am physically fit, have sufficiently trained for
participation in the event and have not been advised otherwise by a qualified medical person. I acknowledge that this Waiver and Release of Liability form will be
used by the event holders, sponsors and organizers of this event and that it will govern my actions and responsibilities in connection with this event.
In consideration of my application and for permitting me to participate in this event, I hereby take action for myself, my executors, administrators, heirs, next of kin,
successors, and assigns as follows: (A) I HEREBY WAIVE, RELEASE AND DISCHARGE the City of Bluffton, Indiana, the Mayor of Bluffton, the Common Council
of the City of Bluffton, the Bluffton Board of Public Works and Safety, the Department of Parks and Recreation of the City of Bluffton, the members of the Board of
Parks and Recreation for the City of Bluffton, the event holders, the event sponsors, Wells County, the Board of Commissioners of Wells County, the Wells
CountyCouncil, and any agents, successors, assigns or employees of any of the foregoing (hereinafter collectively “the Releasees”) from any and all claims or
liabilities for death, personal injury, property damage, theft or damages of any kind, whether or not attributable to the negligence of the Releasees, which arise out of
or are in any way related to my participation in this event or traveling to and from this event. (B) I HEREBY INDEMNIFY AND HOLD HARMLESS the Releasees
as previously identified from any and all liabilities or claims made by other individuals or entities as a result of any of my actions during this event and/or arising out of
my travels to and from this event.
I hereby consent to receive medical treatment, which may be deemed advisable in the event of injury, accident and/or illness during this event. I understand that
at this event or related activities, I may be photographed. I agree to allow my photo, video or film likeness to be used for any legitimate purpose by the event holders,
producers, sponsors, organizers and/or assigns.
This Waiver and Release of Liability shall be construed broadly to provide release and waiver to the maximum extent permissible under applicable law.
I hereby affirm that I am 18 years of age or older, that I have read and understand the foregoing Waiver and Release of Liability and/or have had the opportunity
to discuss it with race officials to my satisfaction.
I understand that my entry fee into this event is non-refunable. In the unlikely event that it is cancelled due to extreme weather conditions or safety concerns, my
entry fee will be used a donation to the Bluffton Parks Department.
Date___________
Signature ___________________________________________
Printed Name_____________________________________________
PARENT/GUARDIAN WAIVER AND RELEASE OF LIABILITY FOR MINORS
I, the undersigned, being the parent or legal guardian of the participant who is less than 18 years of age, hereby represent that I have read and understand the
foregoing Waiver and Release of Liability. In my capacity as parent./guardian of the participant, and on behalf of the participant, the participant's estate, assigns and
successors in interest, I hereby agree to waive and release from liability each of the Releasees as identified above in the same manner as indicated above.
________________________________
_____________________________________
Parent/Guardian Signature for Minor
Printed Parent/Guardian Name