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    Reg Form

    Uploaded by

    Linda Valdez
    This document is a registration form for several trail running events organized by Generic Events between October 2010 and May 2011. It collects the runner's contact information and emergency contact. The runner selects the race(s) they want to register for and the fees are listed, with early registration prices noted. It also includes liability waivers releasing the organizers from responsibility for any injuries and allowing the use of images for publicity. Signing confirms acceptance of the terms including no refunds for cancellations.

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    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd

    Reg Form

    Uploaded by

    Linda Valdez
    12 views1 page
    This document is a registration form for several trail running events organized by Generic Events between October 2010 and May 2011. It collects the runner's contact information and emergency contact. The runner selects the race(s) they want to register for and the fees are listed, with early registration prices noted. It also includes liability waivers releasing the organizers from responsibility for any injuries and allowing the use of images for publicity. Signing confirms acceptance of the terms including no refunds for cancellations.

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    This document is a registration form for several trail running events organized by Generic Events between October 2010 and May 2011. It collects the runner's contact information and emergency contact. The runner selects the race(s) they want to register for and the fees are listed, with early registration prices noted. It also includes liability waivers releasing the organizers from responsibility for any injuries and allowing the use of images for publicity. Signing confirms acceptance of the terms including no refunds for cancellations.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    12 views1 page

    Reg Form

    Uploaded by

    Linda Valdez
    This document is a registration form for several trail running events organized by Generic Events between October 2010 and May 2011. It collects the runner's contact information and emergency contact. The runner selects the race(s) they want to register for and the fees are listed, with early registration prices noted. It also includes liability waivers releasing the organizers from responsibility for any injuries and allowing the use of images for publicity. Signing confirms acceptance of the terms including no refunds for cancellations.

    Copyright:

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    Download as PDF, TXT or read online from Scribd
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    of 1

    FOR OFFICE USE

    CASH / CHECK $

    RACE NUMBER

    2010 REGISTRATION FORM

    ees = ail In F

    $3.00

    First Name:_____________________________________ Last Name:________________________________________ Address:_________________________________________________________________________________________ City:_______________________________ State:_____ Zip:__________Phone:(________)_______________________ E-mail_________________________@_____________________ Birth Date:______/______/______ Gender: M F T-shirt size (circle one): S M L XL XXL

    Emergency Contact: _____________________ Phone:(_____)_______________

    REGISTRATION FEES PER EVENT - Check the box(es) of the registered event(s) + Mail In Fee of $3.00:
    XTERRA POINT MUGU TRAIL RUN (Malibu) - 10/3/10: [ ] 11k [ ] 18k 11k through Aug. 26, $40 Aug. 27 - Oct. 1, $45 18k through Aug. 26, $55 Aug. 27 - Oct. 1, $60 XTERRA TOPANGA TURKEY TROT (Topanga) - 11/25/10: [ ] 5k [ ] 10k [ ] 15k 5k through Oct. 18, $35 Oct. 19 - Nov. 23, $40 10k through Oct. 18, $40 Oct. 19 - Nov. 23, $45 15k through Oct. 18, $55 Oct. 19 - Nov. 23, $60 XTERRA CRYSTAL COVE TRAIL RUN (Orange County) - 12/12/10 [ ] 5k [ ] 17k 5k through Oct. 1, $40 Oct. 2 - Dec. 10, $45 17k through Oct. 1, $75 Oct. 2 - Dec. 10, $80
    XTERRA BONEY MOUNTAIN TRAIL RUN (Thousand Oaks) - 01/09/11: [ ] 7k [ ] 21k 6k through Dec. 4, $35 Dec. 5 - Jan. 6, $40 21k through Dec. 4, $60 Dec. 5 - Jan. 6, $65

    XTERRA MISSION GORGE RUN (San Diego) - 02/06/11: [ ] 5k [ ] 15k 7k through Jan. 1, $35 Jan. 2 - Feb. 3, $40 15k through Jan. 1, $60 Jan. 2 - Feb. 3, $65 XTERRA BLACK MOUNTAIN (San Diego) - 03/12/11: [ ] 5k [ ] 15k 5k through Feb. 18, $35 Feb. 19 - March 10, $40 15k through Feb. 18, $55 Feb. 19 - March 10,$60 XTERRA MALIBU CREEK XDURO (Malibu) - 05/7/11: [ ] 6k [ ] 22k 6k through April 9 $35 April 10 - May 5, $40 22k through April 9, $60 April 10 - May 5, $65 Generic Events 825 Wilshire Blvd. #431 Santa Monica, CA 90401

    Please have cash for parking fees at all events. Mailed-in registrations must be RECEIVED five days prior to the dates shown to the left. Make checks payable to Generic Events and mail to:

    THIS DOCUMENT AFFECTS YOUR LEGAL RIGHTS. PLEASE READ CAREFULLY BEFORE SIGNING.
    ASSUMPTION OF RISK FOR BODILY OR PERSONAL INJURY AND ILLNESS. I voluntarily wish to participate in the XTERRA SOCAL TRAIL RACE EVENTS (the "Event(s)"). I know that running in the mountains on trails and fire roads is a potentially hazardous activity. I shall not enter and run in the Event(s) unless I am medically able and properly trained. I agree to abide by any decision of an Event(s) official relative to my ability to safely complete the Event(s). I assume all risks associated with participating in the Event(s) including, but not limited to, high heat and/or humidity, rainy or wet conditions, the conditions of the trails, all injuries or death that may be suffered by me before, during, or after the Event(s), all such risks being known and appreciated by me. I understand that the Event(s) involves mountain trails, away from medical services, and that there are rattlesnakes, mountain lions, ticks, poison oak, and other potentially dangerous and harmful elements in the area. Knowing these facts, and in consideration of your acceptance of my Event(s) entry, I, the undersigned participant (and if participant is under 18 years of age, I, the parent or guardian of participant), for myself, my marital community, heirs, personal representatives, and assigns, hereby waive, covenant not to sue, RELEASE and DISCHARGE Generic Events, Generic LLC, California Emergency Mobile Patrol, Malibu Creek State Park, Point Mugu State Park, Topanga State Park, Crystal Cove State Park, San Diego Parks, Mission Trails Regional Park, Black Mountain Regional Park, Roberts Regional Park, Redwood Regional Park, Tilden Regional Park, California Department of Parks and Recreation, East Bay Regional Park District, the United States of America, the National Park System, and all of their directors, officers, employees, volunteers, sponsors, representatives and agents (collectively, the "Event(s)" Parties) from any and all liability, loss, damage, claim, action or demand arising from or attributable to my participation in and travel to and from this Event(s), including, but not limited to, liability that may arise out of negligence or carelessness of the Event(s) Parties. I attest that I am physically fit and sufficiently trained for this, my physical condition verified by a licensed M.D. during the last 6 months. PUBLICITY. I hereby release to the Event(s) Parties full and exclusive rights to record my performance in this race on film, videotape, or still photography for use without compensation to me. I also agree to receive email updates and communications. NO REFUNDS. I understand that the entry fee is non-refundable and non-transferable. I also understand the Event(s) will take place rain or shine, at Race Director's discretion. Race may also be postponed due to natural hazards uncontrollable by Race Director. If race is postponed for any reason, there are no refunds and entry fee will be forwarded to the rescheduled date. I have carefully read and fully understand this agreement. I am aware that this is a release of liability, a promise not to sue, and a contract between my self and the Event(s) parties that will bind my marital community, heirs, personal representatives, assigns, and all members of my family, including any minors, and I sign this agreement of my own free will.

    WAIVER AND RELEASE OF LIABILITY

    PRINT NAME:_____________________________________ SIGNATURE:______________________ DATE:___/___/___

    PRINT NAME:___________________________________ SIGNATURE:____________________ DATE:___/___/___


    Parent or legal guardian if participant is under 18 years of age:

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