1st Annual Flight of the Eagle 5K

1st Annual Flight of the Eagle 5K
Liberty High School Booster Club
May 2, 2015, 7:30 AM
at Liberty High School
Packet Pick Up at Liberty High School
Friday, May 1 from 3:00 PM to 7:00 PM
Registration Form
One registration form is required per participant.
I plan to:
____Run
____Walk
Last Name______________________________ First Name
Address
City___________________________ State________ Zip
Phone__________________________ Email
Date of Birth _____ / _____ / __________ Gender
T-Shirts will be provided to all runners registered by Friday, April 24. Available sizes:
YOUTH:
S
Entry Fee: $20.00
M
L
ADULT:
S
M
L
XL
XXL
(Circle one)
Make checks payable to: Liberty High School Booster Club
Waiver: In consideration of this entry, being accepted, I hereby for myself waive and release any claims
that I may have against sponsors involved in the Flight of the Eagle 5K. I certify that I am physically able
to participate in this event and have properly trained. I agree to abide by any decision of the race official
relative to my ability to safely complete this event. I assume all risks associated with running in this event
including but not limited to falls, contact with other participants, and the effects of weather including heat,
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 in consideration of you accepting my entry, I, for myself and
anyone entitled to act in my behalf, waive and release Liberty High School Booster Club, Wentzville
School District, and all sponsors, their representative and successors from all claims or liabilities of any
kind arising out of my participation in this event.
Print Name_____________________________________________ Date
Signature
(Parent/Legal Guardian must sign if participant is under the age of 18)
Send your completed registration form and entry fee to: Liberty High School Booster Club
Attn: Flight of the Eagle 5K
2275 Sommers Road
Lake St. Louis, MO 63367