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Society Hill, SC

5K Run/Walk Entry Form

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5K Run/Walk
5K Run/Walk Entry Form
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Entry Form - Fee $10.00 (Pre-Registration)
                           $12.00 (Race Day Registration)

Name:                                                                                                              
 
Address:                                                                                                          
 
City:                                             State:            Zip:                                        
 
Telephone:                                                                                                      
 
Event: Run                                     Walk                                                          
 
Age:                                              Sex:                  Male                Female
 
Mail Check and Entry Form to:
 
Ann Breckenridge
Town of Society Hill Catfish Festival
PO Box 523
Society Hill, SC 29593
 
Make checks payable to
Society Hill Catfish Festival

Official Waver

I know that participating in a road race or walk is a potentially hazardous activity.  I should not participate 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 event.  I assume all risks associated with other participants, the effects of the weather, including high heat and/or humidity, cold temperatures, traffic and the conditions of the road or trails, all such risks being known and appreciated by me.  Having read this waiver and knowing these fact and in consideration of your accepting my entry, I for myself and anyone entitled to act on my behalf, waive and release the Town of Society Hill, the Society Catfish Festival, sponsors, their representatives and successors from all claims of liabilities of any kind arising out of my participation in this event.  I grant permission to all of the foregoing to use any photographs, motion pictures, video, recordings, or anyother record of this event for any legitimate purpose.  I also understand that the entry fee is non-refundable.
 
 
Signature                                                               Date                             
 
 
                                                                             Date                            
Parent's Signature if entrant is under 18 years of age

Society Hill, SC 29593
 
 
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