RUN
FOR THE HEART 5K
SATURDAY,
OCTOBER 18, 2008
8:00 A.M.
Run for the Heart is sponsored by the Heart Hospital of Lafayette. All proceeds will benefit the Lourdes Foundation, Inc.
Location: Heart
Registration: At Heart Hospital of Lafayette, by mail or race day
Mail Entry:
Attn: Claudia Neef
Entry Fee: $15 until October 10
$20 after October 10
($2 discount to CRRC Members)
Make checks payable to Heart Hospital of Lafayette
Awards: 1st & 2nd Male & Female Overall
1st & 2nd Male & Female in the following age groups:
14 & under, 15-19, 20-29, 30-39, 40-49, 50-59, 60 & over
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Name:
Address:
City: State: Zip
Phone: Sex: M F Age (race day)
Shirt Size: ____S ____M ____L ____ XL
In consideration of this
race, I, for myself, my heirs, executors, administrators and assigns waive
and release any and all rights and
claims for damages I may have against Heart Hospital of Lafayette, any race
officials, association sponsors, their representatives, successors, and assigns
for any injuries suffered by me in said event.
I attest and verify that I have full knowledge of the risks involved in
the race, that I assume those risks, that I will assume and pay my own medical
and emergency expenses in the event of an accident, illness, or other
incapacity, regardless of whether I have authorized such expenses, and that I
am physically fit and have sufficiently trained for the completion of this
event. I hereby grant permission for any
officials associated with this event to use any photographs, videotapes or
audio recordings from this event as they deem appropriate.
Signature of participant:
Signature of Parent (if under
18):