Waynesburg Rain Day Race (iPO Event Id#: 7535)
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Make checks payable to Greene County Habitat for Humanity.
Mail: Greene County Habitat for Humanity, 32 Church Street, Waynesburg, PA 15370
Sign Up for: ___ Children's 1 Mile $10 by July 24, $12 after ___ Rain Day 5K RUNNER $15 by July 24, $18 after ___ Rain Day 5K WALKER $15 by July 24, $18 after NAME_______________________________________________________ ADDRESS____________________________________________________ ___________________________________________________________ PHONE______________________________________________________ E-MAIL_____________________________________________________ AGE AS OF 7/29/06______________ GENDER_____________________ ADULT SHIRT SIZE: M L XL XXL KID'S SIZE: S M LIn consideration of the acceptance of this application and intending to be legally bound, I hereby waive, discharge, and release myself and my heirs, successors, administrators, and executors, of any and all claims, damages, and causes of action of what so ever kind including negligence, that I may have as a challenge and Children's Run, and all their repective heirs, successors, administrators, and executors, asides, trustees, and parent subsidaries or affiliated companies if any. In addition, as an inducment for the acceptance of this application, I hereby certisfy that I have adequately trined for this event and I am fully aware of the risks posed by motor vehicle traffic on the course. I further certisfy that I have read and have full understanding of its contents.
___________________________________________________________ SIGNATURE DATE ___________________________________________________________ SIGNATURE OF PARENT/GUARDIAN if under 18 DATE