Online Registration

HELLUVA RUN 2012
 

Team Release Form

Print out and bring the signed waiver to pre-registration or to the race.  You  must have the form completed and turned in prior to event start.

Please printout the following Release Form and have each of your participating team members sign their agreement to the following. (Parent must sign if runner is under 18 years old)

TEAM RELEASE FORM

Waiver: In consideration of the acceptance of my entry, I, for myself, my executors, administrators and assigns do hereby release and discharge the “helluva run” run, the Boy Scouts of America, its agents, representatives or affiliates, and any and all other sponsors jointly and severally, for any and all claims of injuries or damages incurred by me as a result of or in connections with said event. I attest and verify that I have full knowledge of the risks involved in the event and am physically fit and trained to participate in this event. (caution! be aware there will be vehicle traffic on the roads at all times)
Team Name: _____________________________________________________
Address: _______________________________________________________________
City: ____________________________      State: ____________    Zip: ______________
Team Captain Phone:___________________ Team Captain Email: ___________________

Team Member #1: _________________________
PRINT NAME                                          		 _________________________
RELEASE SIGNATURE
Team Member #2: _________________________
PRINT NAME                                          		 _________________________
RELEASE SIGNATURE
Team Member #3: _________________________
PRINT NAME                                          		 _________________________
RELEASE SIGNATURE
Team Member #4: _________________________
PRINT NAME                                          		 _________________________
RELEASE SIGNATURE
Team Member #5: _________________________
PRINT NAME                                          		 _________________________
RELEASE SIGNATURE
Team Member #6: _________________________
PRINT NAME                                          		 _________________________
RELEASE SIGNATURE

Print out and bring the signed waiver to pre-registration or to the race. You must have the form completed and turned in prior to event start.