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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
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