October 24, 2009 Spirit Run Entry Form
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Last Name First Name
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Street Address
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City State     Zip Code
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Age Birth Date / Age Group
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Phone # email
Gender: (Circle One)            Male             Female
T-shirt (Circle One)            S      M      L      XL      XXL
Race: (Circle One)             2K             5K             10K
Entry Fee:
       $10.00 Pre-Registration-Children, must be received by October 13)
$20.00 Pre-Registration-Adult, must be received by October 13)
$25.00 Adults – race day
$15.00 Children (11-18) - race day
$10.00 Children (10 and under, Race day and Pre-Registered)
$10.00 All ages on the 2K
All Proceeds go to Lake Cities Spirit of Christmas
Make Payable to Lake Cities Spirit of Christmas
Donations Welcomed
Mail Entry Form to:
Spirit of Chriatmas
P.O. Box 806
Lake Dallas, TX 75065
All participants must read and sign the following waiver.
I acknowledge that running near automobiles and bicycles is extremely dangerous and that running in the heat is an extreme test of a person’s physical and mental limit and there exists the potential for death or serious injury. I certify that I am physically fit, have sufficiently trained for this event, and have not been advised otherwise by a qualified medical person. I also certify that I will drink plenty of water before, during and after the event. I assume the risks of participation and assume full responsibility for injury, accident, or illness, which may occur during the event or while I am on the premises of the event and I hereby release and hold harmless the sponsors, promoters and all persons and entities associated with the event, from any and all injury or damage whether it be caused by negligence of the sponsors, promoters or other persons or entities associated with this event or otherwise. Further, I hereby grant full permission to any and all of the foregoing to use photographs, videotapes, motion pictures, recordings or any other record of this event.
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Signature of Particpant (Parent's if minor)
Date