THE EPIC 50K FUN RUN
AUGUST 12 2006 SILVERTON COLORADO
Name: Age:
City, State: Sex:
EMAIL:
QUALIFICATION:
EMERGENCY CONTACT NAME: PHONE #:
FEE: $50 PLEASE MAKE CHECKS PAYABLE TO: JAMES VARNER
MAIL TO: PO BOX 6411, OLYMPIA, WA 98507
It's Highly Recommended that you obtain a Colorado Hikers Permit
THIS ENTRY CONTAINS LIMITATIONS TO YOUR LEGAL RIGHTS SO YOU BETTER READ IT!
Waiver: In consideration of acceptance of my entry in this race: I hereby agree to comply with the rules, conditions, and regulations of the event and instructions of the race director. I am aware that an ultramarathon/ trail run can be difficult, hazardous AND POSSIBLY DEADLY for even well conditioned athletes under the most favorable conditions. I hereby attest and certify that I am physically fit and sufficiently trained for this race and that my condition has been tested by running long distances in the mountains. I hereby for myself, my heirs, executors and administrators, waive, release and discharge the race, its directors, its volunteers, sponsors, the city of Silverton, San Juan County, each and every private property owner along the course, medical staff and anyone else involved in the run from any and all claims and/or liability for any damage, for any and all injuries to me or my property, or for liability for damage caused by me or anyone else arising from my participation in this event and related activities. I will assume and pay for my medical and emergency expenses in the event of an accident, illness or other incapacity, regardless of whether I have authorized such expenses. Please make a copy of this completed form for your records.
Signature: Date: