W&OD TRAIL 5K

By entering this event, I agree, warrant and covenant as follows: I know that running is a potentially hazardous activity. I should not enter or run in competitive runs 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 race including, but not limited to, falls, contact with other participants, the effects of weather, including high heat and/or humidity, the conditions of the road and traffic on the course, all such risks being known and appreciated by me. Having read this waiver and knowing these facts, and in consideration of your acceptance of my application, I, for myself and anyone entitled to act on my behalf, waive and release Northern Virginia Regional Park Authority, RRCA, USATF, Marathon Charity Cooperation, Friends of the W&OD Trail, and all sponsors, their directors, officers, employees, agents; representatives and successors from all claims or liabilities of any kind arising out of my participation in this event even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I acknowledge that the application fee shall be non-refundable. I agree that the organizers of this event may use my name and likeness for publicity purposes.

Name ________________________________________________________ Gender [___] (M | F) Age on 3/27/2010 [__ __] Address _____________________________________________________ Birthday ____ ____-____ ____-____ ____ ____ ____ (mm-dd-yyyy) City ST ZIP _________________________________________________ Phone ____ ____ ____-____ ____ ____-____ ____ ____ ____ E-mail ______________________________________________________ T-shirt [___] (S | M | L | X) Best 5K __ __:__ __ Where/When?______________________________ [___] I will push a baby-stroller (start at 4:01 PM) Enclosed is my entry fee, payable to MCC: ADULTS HIGH SCHOOL STUDENTS [__] $20 by December 31, 2009 [__] $10 by December 31, 2009 [__] $25 by January 31, 2010 [__] $15 by January 31, 2010 [__] $30 by February 28, 2010 [__] $20 by February 28, 2010 [__] $35 by March 24, 2010 [__] $25 by March 24, 2010 [__] $50 on March 27, 2010 (race-day before 3:45 pm) [__] $40 on March 27, 2010 (race-day before 3:45 pm) [__] Enclosed is an additional tax-deductible donation $___ to MCC $___ to FoWOD


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