MCRRC Run for Roses 5K entry form

Mail Entry and fee to: MCRRC, 1905 Mica Drive, Silver Spring, MD 20904

For Official Use Only

 

Instructions: Make checks payable to MCRRC. Do not mail after June 14. Please mark all items and sizes.

Name (last,first)

Address

City

State

Zip

 

Age on Race Day

Club

Evening Phone

 

 

Mother/Daughter Team Name

(separate entry required for each runner)
Race Entry $10 through June 10; $15 from June 11 through race day.
Technical t-shirt ($17), Women's      S     M     L     XL
MCRRC Beginning Women Runners Program?     Yes

 

 

 

Other Beginners Program (please list group or club)___________________

Entry and waiver MUST be signed by runner (parent or guardian if runner is under 18).
I know that running is a potentially hazardous activity and that I should not enter and run in this race unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely compete in the run. I assume all risks associated with running including, but not limited to, falls, weather conditions, contact with other participants, the effects of the road and traffic on the course, all such risks being known and appreciated by me. Having read this waiver and knowing these facts, I, for myself and anyone entitled to act on my behalf, waive and release the Montgomery County Road Runners Club, Montgomery County Government, the Maryland National Capital Park and Planning Commission, RRCA, plus all event partners, sponsors, volunteers, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this race even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for any legitimate purpose. If I am signing this waiver as parent or legal guardian on behalf of the minor(s) named above, I agree to be responsible for the conduct and safety of the minor(s), and I recognize and assume the risks described above on behalf of those minor(s). For safety reasons, I agree not to run with any of the following: wheelchairs, strollers, baby joggers, skates, pets, or headsets.


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Entry must be signed by runner (or parent if runner is under 18)   Date