Horsetooth Half-Marathon & Relay
Fort Collins, Colorado
April 19, 2003
Registration Form (print legibly) BIB #: _______________
Walkers check this box ______ (walkers start early at 8:00 am)
Name _________________________________ Sex: M F
Address ____________________________________________
City ______________________ State ________ Zip ________
Phone ______________________ Age on race day __________
T-Shirt Size (circle one) S M L XL
Relay Information (circle one) Coed Men Women
Relay Team Name _____________________________________
Note: Each relay team member must fill out a separate entry form
and entries submitted together. No Day of Race Registration is
available for relay teams.
Amount Enclosed _____________ Cash / Check / Credit Card
(circle one) -- make checks payable to Ft. Collins Running Club
Card Number ______________________ Exp Date __________
(circle one) Visa / MC / AMX / DIS
Release Waiver Statement: In consideratino of the acceptance of my
entry,
I, the undersigned participant, for myself, my family memebers, heirs,
administrators,
personal representative, successors, and assigns, hereby fully release, discharge
and hold Foot of The Rockies, Colorado State University, Larimer County,
Fort Collins Running Club and its members and staff, sponsors, owners, operators
of event motor vehicles and officers, directors, employees, volunteers, and lessors
of any of the foregoing persons or entities from any and all liabilities, whether
resulting from negligence of any aspect of the Horsetooth Half Marathon including
any pre-race and post-race activities. I also expressly convenant with the
aforementioned persons and entities not to sue any such persons or entities.
I certify and represent by my application for entry, that my physical condition is
adequate to compete safely in the Horsetooth Half Marathon and I hereby
acknowledge that the above persons and entities have no obligation to provide
medical care and have not undertaken the responsibility to do so. In the
event I
receive medical care as a result of medical emergency, I hereby consent to such
care
and fully release the person or persons providing such care from any and all
liability,
whether resulting from negligence of otherwise. I also hereby agree that any
faxed
and/or electronically transmitted signature is legally binding.
Signature ___________________________ Date ____________
Parent's signature for
participants under age 18