El Grito 5k Registration Form
For more info see http://www.elgrito5k.org
Complete
all information, include race entry fee of $16, and mail to:
El
Grito 5k, Inc.
3453
Mail-In Deadline: Entries must be received before noon the Saturday prior to race day.
Check one of the following: ___5kRun ___5k Walk Bib #: ___________
Last Name:_________________________First:_____________Shirt size(M, L, XL):___
Street Address:___________________________________________________________
City:________________________________State:_________________Zip:___________
Daytime Phone:_______________________Age (on race day):______ Sex (Circle): F M
Waiver and Release (must be
signed):
I, intending to be legally
bound for myself, my executors, and heirs, waive and release any and all right
I may hold against the sponsors, administrators, race directors and officials
of El Grito 5k Run/Walk of any and all injuries and
or losses sustained by me as a result of participating in this event. I give
consent to use my name and/or likeness for publicity and promotional purposes
without obligation or liability to me. I understand that roller skating, rollerblading, dogs, baby strollers, and headsets are
prohibited. I also understand that my entry fee, once paid, is nonrefundable.
________________________________________________________________________
Signature (If under 18, must be signed by parent or guardian) Date