Mail
to:
AA Sports
4836 SW Western Ave
Beaverton, OR 97005
Event
(Choose One)
First Name / MI / Last Name
ChampionChip Number (if applicable - Example - CE12345)
Street Address
City
State/Province
Zip/Postal Code
Birthdate - mm/dd/yy
Age
Gender
Phone
Email
Division
Special Divisions - Optional
Shirt Size
Check#
Amount Enclosed
WAIVER MUST BE READ, SIGNED AND MAILED WITH ENTRY
OFFICIAL WAIVER: I know that running/walking a road race is a potentially
hazardous activity. I should not enter and 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 run/walk. I assume
all risks associated with participating in this event including, but not
limited to falls, contact with other participants, the effects of weather,
including high humidity, traffic and the conditions of the road, all such
risks being known and appreciated by me. Having read this waiver and knowing
these facts and in consideration of acceptance of my entry, I for myself
and anyone entitled to act on my behalf, waive and release AA Sports,
Ltd., and any and all persons, sponsors and entities, their representatives
and successors from all claims or liabilities of any kind arising out
of my participation even though said liability may arise out of negligence
or carelessness on the part of the persons named in this waiver. I grant
permission for all of the foregoing to use any photographs, motion pictures,
recordings, or any other record of this event for any legitimate purpose.
Parents must sign if participant is under 18 years of age. This is to
certify that my child has permission to complete in this event, is in
good physical condition and that event officials may authorize necessary
emergency treatment. I understand that my email / contact information
might be used for future promotional purposes. I further agree to return
the timing Chip that is been issued to me or to pay a $30 replacement
charge. The Entry Fee is Non-Refundable/Non-Transferable.
Type Full Name
Signature X ___________________________________________________________________
(Signature of Parent or Legal Guardian if participant is under the age
of 18)
Date________________________________________