APPLICATION
Women's Distance Festival - 2008
Reston YMCA, 8:00 AM, Saturday, June 28, 2008
You may register for the 2008 Reston Runners Women's Distance Festival using a printed version of this form. On-line registration is also available. If you mail your registration, read the program waiver carefully. Sign the form. Your signature indicates your understanding of the program waiver.
All race participants will receive a commemorative gift if registered by June 15th. Sign up early!!
Make check payable to: Reston Runners ($25 for entries postmarked by 1 June; $27 for later submissions; Race Day Fee is $30.00)
Mail to: WDF-2008, c/o Donna Rostant, 3217 Navy Drive, Oak Hill, VA 20171
I know 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 agree to abide by any decision of a race official relative to my ability to safely complete the run. I assume all risks associated with running in this event including, but not limited to falls, contact with other participants, the effects of the weather, including high heat and/or humidity, conditions of the road and traffic on the course, all such risks being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of your accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release the Reston Runners and their respective officers, the county of Fairfax, the Reston Association, and all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for any legitimate purpose. I understand that bicycles, skateboards, baby joggers, roller skates, in-line skates, animals, and radio headsets are not allowed in the race and I will abide by this guideline.
Event: 5K Run _______ 5K Walk _______ Number (for official use only): ________
Mother/Daughter or Grandmother/Daughter/Granddaughter Team? ____(Y/N); Team mate(s): __________________________
Name (PLEASE PRINT): Last Name __________________; First Name _________________
Age/DOB: Age on race day: ____yrs; DOB (mm/dd/yy): ____/ ____/ ____
Address:_____________________________________
___________________, _____ ___________
Phone number: (______) _______ -- ____________
Shirt Size ___ Small ___ Medium ___ Large _____X-Large
Sock Size ____ Small _____ Medium _____ Large
e-mail address: ________________________________
Have you previously participated in WTP? YES___ NO___
Participant Signature & Date (mm/dd/yy):
________________________________ ___/___/___
If under 18: Consenting Parent/Guardian Signature & Date
__________________________________________ ___/___/___
ENTRY NOT VALID WITHOUT SIGNATURE