2016 St. Mary’s Love Run
WHEN
Saturday, February 13, 2016 at 9:00am
Late registration 8:00am-8:20am
8:30am 1 mile, 9:00am 5K
LOCATION
Starts and Finishes at St. Mary’s school
Official Entry Form
ENTRY FEE includes:
Long sleeve Race shirt and refreshments after
the race including sausage kolaches, fresh
fruit, hot chocolate, etc.
AWARDS
Awards will be presented to 1st overall male &
female and top 3 in age groups: 12 & under,
13-18, 19-29, 30-39, 40-49, 50-59, 60-69, 7079, 80 & over
ENTRY FEES:
$10 Students
$15 St. Mary’s Alumni
$20 Mail In/ Hand In Due Feb 1st
$25 Late Reg.( Feb 5th)/Day of Race
PLEASE PRINT CLEARLY
Name:
Address:
City, State, Zip:
Email:
AGE ON DAY
OF RACE:
SEX:
MALE
5K
FEMALE
SHIRT SIZE:
YOUTH SMALL
ADULT MED
YOUTH MED
ADULT LARGE
YOUTH LARGE
ADULT XL
ADULT SMALL
ADULT XXL
1 Mile
Make Checks Payable to:
St. Mary’s School
Drop off Entry form at:
St. Mary’s School
Mail Entries to:
St. Mary’s School
P.O. Box 277
West, TX 76691
Alumni
Check Here
Questions: Contact Joanna Rogers at jwolf430@yahoo.com
RELEASE AND INDEMNITY
I, the undersigned below, in consideration of my and/or my child's participation in the ST. MARY”S LOVE RUN ("Event"),
acknowledge that I am aware that my or my child's participation in the Event may result in risks, which among other
things, include but are not limited to contact with Event participants or volunteers or with vehicles; scrapes; bruises;
twisted ankles and various injuries to the body, including death and heat and stress related issues. I further
acknowledge that I freely assume on my own and/or my child's behalf all risks incidental to such participation.
In consideration of my and/or my child's participation in the Event and in my own and/or my child's behalf, and on behalf of my and/or my child's or heirs, executors, administrators and next of
kin, I hereby release, covenant not to sue, and forever discharge the Released Parties (as defined below) of and from all liabilities, claims, actions, damages, costs and expenses of any nature arising out
of, related to, or in any way connected with my or my child's participation in the Event and/or any such related and associated activities. This release extends to and includes any and all claims, actions,
damages, costs and expenses arising out of or related to any act or omission constituting negligence or gross negligence on the part of any of the Released Parties. In further consideration, I agree to
indemnify and hold each of the Released Parties harmless from and against any and all such liabilities, claims, actions, damages, costs and expenses up through and including any appeal, including but
not limited to claims based on negligence or gross negligence, bodily injury (including, without limitation, death), property damage, and loss by theft or otherwise, whether suffered by me or my child either
before, during or after such participation, including the travel to and from the event.
I further declare that I and/or (if participating) my child are physically fit and have the skill level required to participate in the Event and I authorize medical treatment for me and/or my child at
my cost, if the need arises.
For the purposes hereof, the "Released Parties" are: St. Mary’s School, and the City of West, and Event sponsors together with their parents and the parent, subsidiary, affiliated and related
entities of each of them, and the trustees, officers, directors, employees, and volunteers of any of them.
Date__________________________ Signature____________________________________________
Signature of Parent/Guardian______________________________________________________________