Candy Cane 5K
1 Mile Walk
Santa Fun Run (kids 12 & under)
December 6, 2008
1 Mile Walk
Santa Fun Run (kids 12 & under)
December 6, 2008
Race starts 10 a.m.
Starts at West Haven Park 3300 S 2825 W West Haven, UT
Name_____________________________________Age_____Sex____Phone___________________________
Address_________________________________________________
Starts at West Haven Park 3300 S 2825 W West Haven, UT
Name_____________________________________Age_____Sex____Phone___________________________
Address_________________________________________________
City _______ State ____ ZIP________ Circle One: 5K / 1 mile / Santa Fun Run
Email address:________________________
** Pick up pre-registration packets 8 a.m. day of race
T-shirt size: S M L XL
ENTRY FEES
__$20* -5K before pre-registration deadline (must be postmarked by November 29, 2008 After Nov. 29th $25
__$15*- 1 mile walk before pre-registration deadline (must be postmarked by November 29, 2008) After Nov. 29th $20
__$8* – Santa Fun Run *t-shirts available while supplies last, only adult t-shirts available After Nov. 29th $10
ENTRY FEES
__$20* -5K before pre-registration deadline (must be postmarked by November 29, 2008 After Nov. 29th $25
__$15*- 1 mile walk before pre-registration deadline (must be postmarked by November 29, 2008) After Nov. 29th $20
__$8* – Santa Fun Run *t-shirts available while supplies last, only adult t-shirts available After Nov. 29th $10
Register day of race 8 a.m. after deadline entry fees apply
**Make checks Payable to “ Kambree’s Hope”**
(Do not send cash.)
Race Release Waiver: In return for your accepting my entry, I, for myself, my heirs, and my personal representatives, waive and release any and all rights and claims I may have, now or in the future, against all sponsors, their affiliated companies and organizations, sponsors, and all of their officers, employees, representatives, volunteers, successors, and assigns, for any and all injuries, illnesses, losses, damages, or death in any way connected with my entry, traveling to and from, or participation in Candy Cane 5K Run/1 Mile walk and Santa Fun Run. I assume all risks associated with travel to and from the event and participation, including but not limited to falls, contact with other participants and vehicles, effects of the weather, including wet, slippery, icy road conditions and course hazards. I am aware that participation is strenuous and may be hazardous. I am physically fit and sufficiently trained to complete the event, and I agree to abide by all rules and by any decision of a race official relative to my ability to safely complete the run. I authorize all above-named parties to use photos, video, or other record of this event, and any information contained in my application, for any purpose whatsoever, without any consideration due to me. Additionally, I release any of the above-named parties from legal liability associated with sponsoring the event and that have independently obtained insurance for this event. I have read and fully understand this entire application.
____________________________________________________________________________________________________
Signature Print Name Date
___________________________________________________________
Signature of Parent/Guardian (if participant is under 18 years of age)
**Make checks Payable to “ Kambree’s Hope”**
(Do not send cash.)
Race Release Waiver: In return for your accepting my entry, I, for myself, my heirs, and my personal representatives, waive and release any and all rights and claims I may have, now or in the future, against all sponsors, their affiliated companies and organizations, sponsors, and all of their officers, employees, representatives, volunteers, successors, and assigns, for any and all injuries, illnesses, losses, damages, or death in any way connected with my entry, traveling to and from, or participation in Candy Cane 5K Run/1 Mile walk and Santa Fun Run. I assume all risks associated with travel to and from the event and participation, including but not limited to falls, contact with other participants and vehicles, effects of the weather, including wet, slippery, icy road conditions and course hazards. I am aware that participation is strenuous and may be hazardous. I am physically fit and sufficiently trained to complete the event, and I agree to abide by all rules and by any decision of a race official relative to my ability to safely complete the run. I authorize all above-named parties to use photos, video, or other record of this event, and any information contained in my application, for any purpose whatsoever, without any consideration due to me. Additionally, I release any of the above-named parties from legal liability associated with sponsoring the event and that have independently obtained insurance for this event. I have read and fully understand this entire application.
____________________________________________________________________________________________________
Signature Print Name Date
___________________________________________________________
Signature of Parent/Guardian (if participant is under 18 years of age)
