21st Annual Charlie Post Classic

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Charlie Post Classic


      Last Name:  

      First Name:  

Street Address:  

                  City:  

                 State:  

                    Zip:  

               Phone:  

                Email:  

Age On 1/31/04:  

   Date Of Birth:  

                    Sex:
 

                 Event:
 

               T-Shirt:
 

   CRC Member:
 

WAIVER must be signed! In consideration of this entry, I, for myself, my heirs, and assigns, hereby release the sponosrs and officials of the Charlie Post Classic, CareAlliance, and the town of Sullivans Island from any and all liability arising from illness, injury, and damages I may suffer as a result of my participation in this event. I attest that I am physically fit and have trained sufficeintly for this event. I give my permission for free use of my name and picture in any broadcast, telecast, digital or written account of this event. I understand that the entry fee is non-refundable. Should race officials determine that competing in this event would be injurious to my health, I consent to be remove from the course and treated by the physician in attendance or of their direction.

               Waiver:


Electronic Signature parent/guardian if under 18 emergency contact and phone

Guardian Name And Phone:


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