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4. P&R OPEN FORUM 03-09-2016
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4. P&R OPEN FORUM 03-09-2016
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4/13/2016 11:23:13 AM
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4/13/2016 11:20:23 AM
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City Government
type
PRSR
date
3/9/2016
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Age Sex M / F <br />Address <br />City State Zip <br />Phone_ Email <br />Circle One 5K Walk 5K Waddle 5K Run T -Shirt Size (Adult Sizes) S M L XL 2XL <br />Kids Fun Run (No Charge) Optional Kids T -Shirt - $15 (Circle Size Above) <br />I assume all risks associated with running this event. Having read this waiver and knowing these facts and in <br />consideration of accepting my entry, I and anyone entitled to act on my behalf, waive and release BTBL, the City of <br />Elk River, all race volunteers, all sponsors, their representatives, employees and successors from any claims and <br />liabilities of any kind arising out of my participation in this event or carelessness of the persons named in the <br />waiver. Further, I grant to all of the foregoing the right to use any photos, recordings or any other record of this <br />event for legitimate purposes. I understand that all fees are not refundable. <br />Signature <br />Entry Fee of $25 if pre -registered by April 22, $30 April 23 - May 14 (Race Day) <br />Make checks payable to BTBL and list Participant's Name in Memo Line <br />Mail this form and payment to Gwen Besser H PO Box 165 • Elk River MN 55330 <br />A&M CB"011 <br />PO Box 165 <br />Elk River, MN 55330 <br />
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