Rittman Lions Club 5K

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Run or Walk on Saturday, June 29 th at 9:00 a.m Starting on the Rails to Trails 80 Grant St. Rittman, OH 44270 Race Day Registration and sign in begins that Saturday at 8:00 a.m. and closes at 8:45 a.m. at New Prospect Station T-Shirts to all participants. Medals given to the top 3 men & women finishers. Cost: $25 if registered prior to June 15 th , $30 if registering on day of event. *Must be 10 years of age on race day* *Make checks payable to Rittman Lion’s Club* Please complete entry form, and return form and check to: Rittman Lions Club 75 North Third Street Rittman, OH 44270 Deadline: June 14, 2013 Stop by BGs Main Event after the race to refuel with some post race breakfast specials! INCOMPLETE OR UNSIGNED ENTRY FORMS WILL NOT BE ACCEPTED. In consideration of my entry being accepted, I intend to be legally bound, and do hereby, for myself, my heirs, executors, waive and release all rights and claims for damages which may have or which may here in after accrue to me against, Rittman Lions Club, City of Rittman, Volunteers, and the sponsors of the event which I am entering, any subsidiary or political division thereof, of their respective officers, agents, directors, representatives, successors, assigns, and sponsors for any and all damages or injuries which may be sustained and suffered by me in connection with my association with entry or participation in the Rittman Lions Club 5k as is mentioned above. If I should suffer injury or illness I authorize officials of the race to use their discretion to have me transported to a medical facility, and I take full responsibility for these actions. I attest and certify that I am physically fit and have sufficiently trained for the completion of this event. I hereby grant full permission to any and all of the foregoing to use any photographs, videotapes, motion pictures, recordings or any other record of this event for any purpose. I HAVE READ THE ABOVE RELEASE AND UNDERSTAND THAT I AM ENTERING THIS EVENT AT MY OWN RISK. First Name: ____________________Last Name:

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Registration form for Rittman Lions Club 5k

Transcript of Rittman Lions Club 5K

Page 1: Rittman Lions Club 5K

Run or Walk on Saturday, June 29th at 9:00 a.mStarting on the Rails to Trails 80 Grant St. Rittman, OH 44270

Race Day Registration and sign in begins that Saturday at8:00 a.m. and closes at 8:45 a.m. at New Prospect Station

T-Shirts to all participants. Medals given to the top 3 men & women finishers.

Cost: $25 if registered prior to June 15th, $30 if registering on day of event.

*Must be 10 years of age on race day* *Make checks payable to Rittman Lion’s Club*

Please complete entry form, and return form and check to:Rittman Lions Club

75 North Third Street Rittman, OH 44270

Deadline: June 14, 2013

Stop by BGs Main Event after the race to refuel with some post race breakfast specials!

INCOMPLETE OR UNSIGNED ENTRY FORMS WILL NOT BE ACCEPTED. In consideration of my entry being accepted, I intend to be legally bound, and do hereby, for myself, my heirs, executors, waive and release all rights and claims for damages which may have or which may here in after accrue to me against, Rittman Lions Club, City of Rittman, Volunteers, and the sponsors of the event which I am entering, any subsidiary or political division thereof, of their respective officers, agents, directors, representatives, successors, assigns, and sponsors for any and all damages or injuries which may be sustained and suffered by me in connection with my association with entry or participation in the Rittman Lions Club 5k as is mentioned above. If I should suffer injury or illness I authorize officials of the race to use their discretion to have me transported to a medical facility, and I take full responsibility for these actions. I attest and certify that I am physically fit and have sufficiently trained for the completion of this event. I hereby grant full permission to any and all of the foregoing to use any photographs, videotapes, motion pictures, recordings or any other record of this event for any purpose. I HAVE READ THE ABOVE RELEASE AND UNDERSTAND THAT I AM ENTERING THIS EVENT AT MY OWN RISK.

First Name: ____________________Last Name: ________________________

Phone Number: ______________________ Age on Race Day ______________

T-Shirt size (Circle): Small Medium Large Extra LargeSignature:______________________________________________________Guardian Signature if under 18 years of age:_____________________________