Registration Form
Roadkill Run 5K
September 13, 2008 1:00 PM

  • Fill out this form with your browser, print it, sign, and mail to:
    Armadillo Resort
    400 Perkins Rd
    Poolville, TX 76487
  • $20 if entry is postmarked by September 8, 2008. $25 after September 8, 2008.
  • Make checks payable to Armadillo Resort
  • For more information, call 817-599-6833 or E-Mail info@armadilloresort.com.

 

 

 

First Name

Last Name

Address

City

State

Zip

E-mail

Phone

Age on
Sept 13, 2008

Date of Birth

Gender

 Male   Female

T-shirt size

 M    L    XL

If you will be bringing a spouse or significant other to participate as a volunteer, please enter their name

 

 

The following waiver must be signed and submitted with registration:

WAIVER OF CLAIM
I know that running and participating in this event is potentially hazardous. I should not enter and run in this event unless I am medically and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete this race. I assume all risks associated with running in this event including, but not limited to falls, contact with other participants, effects of the weather including high heat and humidity, the condition 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 acceptance of my entry, I for myself or anyone entitled to act on my behalf, waive and release Armadillo Resort, the Southwestern Sunbathing Association, the American Association for Nude Recreation and any individual or group associated with this event from all claims and liabilities of any kind arising out of my participation in this race even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I also authorize “Roadkill Run” personnel permission to select location for any medical treatment I might need in case of injury.

_______________________________________________________________________________________
 Signature                                                   Date
(Must be at least 18 years of age as of September 1, 2008 to sign form.)