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Jimmy Williams Memorial 5K Run Registration Form PowerPoint Presentation
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Jimmy Williams Memorial 5K Run Registration Form

Jimmy Williams Memorial 5K Run Registration Form

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Jimmy Williams Memorial 5K Run Registration Form

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  1. Jimmy Williams Memorial 5K Run Registration Form Saturday, May 3, 2014 at 10am at Willow Metropark 22900 Huron River Drive, New Boston, MI 48164 • Event Cost: • Early Registration $25 – by April 5, 2014 • Late Registration $30 – between April 6 and April 30, 2014 • Day of Race $35 Mail Entries to: Jimmy Williams Memorial Run 26070 Whispering Willows Drive New Boston, MI 48164 Name: _________________________________________ Address: _______________________________________ City: _____________ State: _____ Zip Code: _________ Telephone: ______________ E-mail: ________________ Gender (M/F): ______ Age (on 5/3/14): ________ Select T-Shirt Size: Youth S M L XL Adult S M L XL In consideration of acceptance of my race entry, I, for myself, my executors, administrators, and assignees, do hereby release and discharge the Jimmy Williams Memorial Run/Scholarship, the City of New Boston, all sponsors, supporters, participants, and spectators for all claims of damages, demands, actions whatsoever in any manner arising from my participation in said event. I attest and verify that I have full knowledge of the risks involved in this athletic event, am physically fit to participate in this event, and have my physicians approval. Further, I hereby grant full permission to any of the aforementioned to use my photograph, videotape, film, motion picture, or record of my participation in this event. Signature _____________________________________________________________ Parent Signature (if participant is under 18) _____________________________________