Washington's Birthday Marathon Relay Registration Form

10:30 am Sunday, February 14, 2010


Remit with check payable to DCRRC. Mail to: GWBM, c/o Robert Platt, 1300 Army Navy Dr. 209, Arlington, VA 22202

     Team Name: 
Runner #1 Name: 
       Address: 
          City: 
         State:    Zip: 
         Phone: 
        E-Mail: 
 Date of Birth:    Age on 2/14/2010: 
        Gender: F
    Shirt Size: XL

Runner #2 Name:         Address:            City:           State:    Zip:           Phone:          E-Mail:   Date of Birth:    Age on 2/14/2010:          Gender: F
    Shirt Size: XL

Runner #3 Name:         Address:            City:           State:    Zip:           Phone:          E-Mail:   Date of Birth:    Age on 2/14/2010:          Gender: F
    Shirt Size: XL





     Entry Fee: $48* postmarked by February 3, 2010 
                $60* Postmarked after February 3, 2010 and Raceday

                    *Cost is for the entire team

    Relay Team Category: COED Open Men  Open Women Masters Men Masters Women
Waiver Must Be Read and Signed by all runners Before Mailing:

I know that running is a potentially hazardous activity. I should not enter or run in club activities 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 the Road Runners Club of America, the D.C. Road Runners Club, and all sponsors, their 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 grant permission to all of the foregoing to use any photographs, motion pictures, recordings or any other record of this event for any legitimate purpose.

 

_______________________________  _____________ _____________________________________ Runner #1 Signature              Date          Parent's Signature if under 18 _______________________________  _____________ _____________________________________ Runner #2 Signature              Date          Parent's Signature if under 18 _______________________________  _____________ _____________________________________ Runner #3 Signature              Date          Parent's Signature if under 18

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