Burns Day 2022 5K run/walk
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Printable Form:
Burns Day 5k
Printable version at https://docs.google.com/document/d/1iMTGRSScV-VXbOaXv5_oX4ZUcMSiDxwz9drUq0SVT7k/edit?usp=sharing
First Name *
Last Name *
Gender *
Date of Birth *
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Age *
Full Address *
Race Options *
Required
Shirt Size - Adult sizes only *
Liability Agreement
I know that participation in this event is a potentially hazardous activity.  I will not enter or participate unless I am medically able and properly trained.  I agree to abide by any race decision by any race official as to my ability to safely complete the event. I assume all risk associated with this event, including but not limited to: fall, contact with another participant, effects of the weather, including high heat or rain, traffic and condition of the roads, all such risk being known and appreciated by me.
Having read this waiver and knowing these facts, and in consideration of your accepting my entry, I myself, and any entitled to act on my behalf, waive and release  the Burns Day Committee, Town of Burns, race officials, volunteers, and all sponsors from all claims or liabilities of any kind arising out of my participation of this event.

Please type your name below to show you agree to the above statement.   *
Todays Date *
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Payment Options - Please choose one *
Questions?
For any questions, please contact Rick at rlakin@yahoo.com  or 370-640-0318
A copy of your responses will be emailed to the address you provided.
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