Address:

                          City:

                        State:

                            Zip:

                       Phone:

                     E-Mail:

  Age On Race Day:

                    Gender:   Select One Female Male

             T-Shirt Size:   Select One Small Medium Large Extra Large XX Large

Waiver of Participation

WAIVER: I know that running a road race is a potential hazardous activity. I should not enter or run/walk 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 complete the run. I assume all risks associated with running in this event including, but not limited to falls, contact with other participants, the effects of the weather, traffic and the conditions of the road. All such risks being known and appreciated by me. Having read this waiver, and knowing these facts, and in consideration of your accepting my entry, I for myself and anyone entitled to act in my behalf, waive the release Hopkins Township, Epic Race Timing, and any/ all participating sponsors, their representatives and successors from all claims and liabilities of any kind arising out of my participation in this event. I grant all permission to all the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for ANY legitimate purpose. The event director has the right to cancel this even in the case of severe weather. Registration fees are non‐refundable and non‐transferable. I understand and agree to return the rental chip at the end of the race. If I do not return the chip, I understand I am accountable for the $30.00 replacement fee.

    Agree To Waiver:   Select Yes

 Participant Signature: 

Signature above must be signed by parent or guardian if under 18

 

Online Registration Is now Closed.