First Name:

                              Address:

                                     City:

                                   State:

                                       Zip:

Emergency Contact Name And Phone #:

             Day Time Number:

                Evening Number:

                EMAIL Address:

                     Date Of Birth:

         Age As Of Race Day:

                                       Sex: Select One Male Female

                             Shirt Size: Select One Adult Small Adult Medium Adult Large Adult XL Adult XXL Youth Small Youth Medium Youth Large

  Expected Finishing Time:

                                  Event: Select One Run Walk

                             Distance: Select One 1 Mile 5K 10K Half Marathon

         Select Age Category: Select One Youth 17 And Under Adult 18 And Over

Waiver:

I know that Trail Running and Walking are known and potentially hazardous activity. I should not enter and participate unless I am medically able and properly trained. I agree to abide by any decision of the race officials relative to my ability to safely complete this event. I assume all risks associated withy the 2nd Annual Run Trail ½ Marathon 4 The Poor Challenge Benefit including, but not limited to falls contact with other participants, the effects of weather, including northwest weather changes, the conditions of the trails, pathways on the course. I know the risks involved in this event. (Some prescriptions and over-the-counter medications contain banned substances. Information regarding drugs and drug test may be obtained by calling the USOC Drug Hotline at 1-800-233-0393). Having read this waiver and knowing these facts, and in consideration of your acceptance of my applications, I, for myself, and anyone entitled to act on my behalf, waive and release the event, the event director, Washington State Trail Running, Walking and Duathlon Club, City of Lakewood, Pierce County Park and Recreation, and all sponsors, their representatives and successors from all claims or liabilities on any kind arising out of my participation in this event even though that liability may arise out of negligence or carelessness on the part of the person(s) name in this waiver. Further, I hereby grant full permission to any and all of the foregoing to use my name, my voice, and/or my picture in any broadcast, telecast advertising, promotion, or other account of this event for any purposes whatsoever. This event may be covered by the media. This event is Road Runners of America (RRCA) sanctioned. Club/Race management reserved the right to reject any entry and further reserves the right to change the information of the above-referenced event without prior notice. I understand that my entry fee in nonrefundable and bib number is nontransferable. THIS IS AN IMPORTANT LEGAL DOCUMENT. READ CAREFULLY BEFORE SIGNING.

           Agree With Waiver: Select One Yes

I am at least 18 years of age and have read and understand the above waiver.  I am under 18 years of age. My parent or legal guardian has read and understands all the above and is signing this document. He/she consents to my participation in each this event I have selected.

                          Signature:

Online Registration Closed