Falcon 15K Relay Entry Form
Saturday May 31, 2008 - 9:00am
Relay & Individual 8:45am Kids Race
Liberty High School 21945 NW Wagon Way Hillsboro, OR
15K Relay, 5K, 10K & 15K Runs

Website:
http://www.hsd.k12.or.us/liberty/falcon15k/index.html

Official Use Only

Instructions
> Type in your information in the blanks provided.
> Print entry form & SIGN WAIVER (Entry will not be accepted without the signed waiver)
> Make Checks Payable to:
Liberty High School / Falcon 15K Relay

Mail to:
AA Sports, Ltd.
4840 SW Western Ave, Suite 400
Beaverton, OR 97005


Event - Choose One (T-shirt included in entry fee)


First Name / MI / Last Name

Street Address

City

State/Province

Zip/Postal Code

Birthdate - mm/dd/yy (birth year not 2008)

Age

Gender

Phone

Email

Award Division

Special Division (Optional - applies to Individuals only)

T-Shirt Size (each paid participant will receive a custom designed Falcon 15K t-shirt)


RELAY MUST COMPLETE*
* Team Name (20 characters or less)

*
Teammates



* DIVISIONS - RELAY (Combined ages)


Check#

Amount Enclosed



WAIVER MUST BE READ, SIGNED AND MAILED WITH ENTRY
OFFICIAL WAIVER: I know that participating in an organized athletic event is potentially hazardous, and that I should not enter to participate unless I am medically able and properly trained. I HEREBY ASSUME THE RISKS OF PARTICIPATING IN THIS EVENT. I certify that I am physically fit and that I have sufficiently trained. I agree to abide by the competitive rules. I hereby take the following action for myself, my executors, administrators, heirs, next to kin, successors and assigns, or anyone else who might claim or sue on my behalf, and I hereby waive, release and discharge from any and all claims, losses, or liabilities for death, personal injury, partial or permanent disability, property damage, medical or hospital ills, or theft which may arise out of or relate to my participation in this event. I agree not to sue, and to hold harmless any and all persons, sponsors, volunteers, participants, or government agencies for any and all claims or liabilities that I have waived, released or discharges herein. I agree to return the Timing Chip assigned to me or pay a $30.00 replacement fee. ENTRY FEES ARE NON-REFUNDABLE.

Type Full Name


Signature X ___________________________________________________________________
(Signature of Parent or Legal Guardian if participant is under the age of 18)

Date________________________________________