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Entry Form

Relay Entry Form
 


Swiftwater Entry Form 	( MUST BE SIGNED)
 
_________________      _________________________        ________       ___________	M  or  F
First Name                            Last Name                                 Age - Aug 7     Date of Birth     	Gender
 
_______________________________         ___________________      _______       _________
Address                                                                    City                                State                Zip

Email address: _____________________
 
Race (select one)   2 mile    5 mile         T-shirt (select one)    S     M     L     XL    XXL
 
 I,(sign here) _____________________________being over 18 years of age, or as parent or guardian of listed participant, do hereby absolve and hold harmless the Swiftwater Road Race, officials, the Nekoosa School District and the City of Nekoosa from liability incurred by me while participating in the Swiftwater Road Race.  I further provide that this hold harmless agreement applies to my heirs, executors, and assignees, and that I am in good condition for a warm weather race. I also give my permission for Swiftwater officials to use my picture or video for any advertising or for the race website.
 
Mail this SIGNED form with your check payable to: 
Swiftwater Fun Run, 12299 Hollywood Road, Nekoosa, WI  54457

 



Relay Entry Form 	( MUST BE SIGNED)
 
_________________      _________________________        ________       ___________	M  or  F
Name of Captain               Team Name                                 Age - Aug 7     Date of Birth     	Gender
 
_______________________________         ___________________      _______       _________
Address                                                                    City                                State                Zip

Email address: _____________________                        T-shirt (select one)    S     M     L     XL    XXL

(fill out one form per team)


________________________        ________                  T-shirt (select one)    S     M     L     XL    XXL
second team member                        age

Email address: _____________________


________________________        ________                  T-shirt (select one)    S     M     L     XL    XXL
third team member                            age

Email address: _____________________

 
 
I,(sign here) _____________________________being over 18 years of age, or as parent or guardian of listed participant, do hereby absolve and hold harmless the Swiftwater Road Race, officials, the Nekoosa School District and the City of Nekoosa from liability incurred by me while participating in the Swiftwater Road Race.  I further provide that this hold harmless agreement applies to my heirs, executors, and assignees, and that I am in good condition for a warm weather race. I also give my permission for Swiftwater officials to use my picture or video for any advertising or for the race website.
 
Mail this SIGNED form with your check payable to: 
Swiftwater Fun Run, 12299 Hollywood Road, Nekoosa, WI  54457
 
 
http://nekoosarunning.wikispaces.com/Swiftwater+Fun+Run09 Registration_files/entryform.htm09 Registration_files/relayform.htmshapeimage_1_link_0shapeimage_1_link_1shapeimage_1_link_2