Name _______________________ Age on Race Day _______ Date of Birth ___________
Address ______________________________
City/State/Zip _________________________ email please_____________________
Male ___ Female ___ Shirt size: XS ____S___ M____ L____ XL____
How did you hear about us?_____entry mailed to me _____previous participant ____online calendar ____MDRA
____local newspaper _____website searches _____ friend or co-worker ____other
Preregister early to guarantee t-shirt on race day
$15 before June 8
$20 after June 8 and on race day
Online Registration at: www.riverrat5krun.zapevent.com
Send Registration Form and Check to:
River Rat Run, 10904 Harvest Rd., Little Falls, MN 56345
For more information please call: Jacki 320-632-8993 or Chamber of Commerce 320-632-5155
email: devine@clearwire.net
Waiver of Liability: ALL ENTRY FEES ARE NONREFUNDABLE.
I know that running a road race is a potentially hazardous activity. I should not enter and run 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 participating in this event including, but not limited to falls, contact with other participants or spectators, the effects of the weather – including extreme cold or warm temperatures, the conditions of the road surface, all such risks being known and appreciated to 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 for my behalf, waive and release the River Rat Run, the management personnel, and all sponsors of the event, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event even though that liability might arise out of negligence or carelessness on the part of the persons named in this waiver.
I hereby consent to and authorize the use and reproduction, in print or electronic format by the River Rat Run or anyone authorized by the River Rat Run, of any and all photographs which have been taken on this day for any publicity purposes without compensation. All images – electronic, negatives and positives, together with the prints – are owned by River Rat Run. I hereby acknowledge that I have read and understand the terms of this release. If you are under age 18, parent or guardian must sign entry form.
Signature of Participant ______________________________ Date _________________
Signature of guardian if under 18 _______________________
