MAKE CHECKS PAYABLE TO: Hardcore Run
SEND ENTRY FORM TO: Hardcore Run, Kewanee Chamber of Commerce, 113 E. Second St., Kewanee, IL 61443
FOR ADDITIONAL INFORMATION CALL: 309-852-2175
Name _____________________________ Fax ______________Phone _____________
Address _______________________________________ Date of Birth _____________
City _____________________ State _______ Zip __________ Sex ______ Age ______
I know that running/walking a road race is a potentially hazardous activity. I know that I should not enter a run/walk 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 Hardcore Run. I assume all risks associated with running this event. I also know that although police protection will be provided, I assume the risk of running/walking in traffic. Having read this waiver and knowing these facts and in consideration of you accepting my application and non-refundable entry fee, I, for myself and anyone entitled to act on my behalf, waive and release the Kewanee Chamber of Commerce, the city of Kewanee, and all other sponsors, officials, volunteers, their representatives and successors from all claims or liabilities of any kind arising out of my participation in the Hardcore Run. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings or any other record of the Hardcore Run for any legitimate purpose.
UNSIGNED ENTRIES WILL BE REJECTED
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Date _________________ Signed
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(Guardian for Kids Fun Run)
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