NAME:    PHONE:

MAILING ADDRESS:

CITY:   STATE:   ZIP:

AGE:   SEX: Male   Female

RACE:   10K   KIDS   WALK

SHIRT SIZE:   M   L   XL

HOW MANY YEARS HAVE YOU RUN THE GOOSE CREEK RUN-OFF?  

I realize that running a road race is a potentially hazardous activity. I should not enter and run unless I am medically able and properly trained. I assume all risks associated with running this event including, but not limited to, falls, contacts with other participants, effect of weather, traffic, and conditions of the road. I am aware of all such risks and accept them. I have read this waiver and, knowing these facts, waive and release sponsors, their representatives, and successors, from all claims of liabilities of any kind arising from my participation in this event, even though that liability may arise from negligence or carelessness on the part of the persons named in this waiver.

SIGNATURE:_________________________________________   RUNNER#:_____________

Entrant must sign (parent must sign if entrant is under 18 years of age)  
For more information contact Becky Woodhouse at 208-862-3809
or Michelle Marchant at 208-862-9235