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Frank Shorter Mile Paper Registration form

November 06, 2018 5:38 PM | Betsy Suda (Administrator)

Frank Shorter Mile

NYE 2018!

  

Men’s heat: 4PM, Kids’ 800m Mustache Dash: 4:20, Women’s heat: 4:35PM (times may change slightly, but first race will be no earlier than 4PM)

 

If mailing in entry please send this form to:

 Florida Track Club (Frank Shorter Mile)

c/o Betsy Suda

4444 NW 35th St

Gainesville, FL 32605

Mail in entry deadline: December 28th  Day of registration will close @3:30 p.m.

 

Last Name  ________________________First Name  _________________________________

 

Gender (check one):   oM   oF     Age (race day)  __________________________________

 

Address  ______________________________________________________________________

E-mail Address _________________________________________________________________

                                                                                                       

Contact phone number  __________________________________________________________

 

 

FTC Member?  oYES                        oNO

 

Interested in joining the Florida Track Club ($30/year)? See the benefits at www.floridatrackclub.wildapricot.org

                                         

Early registration $20 ($15 FTC)               Race day $25        Total enclosed $  ____________ 

Kids under 12 - FREE                       

 

I know that running a road race is a potentially hazardous activity.  I should not enter and run 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 run. I assume all risks associated with running in this event including, but not limited to: falls, contact with other participants, the effects of weather, traffic, and the conditions of the road, all such risks being known and appreciated by me. Having read this waiver and understanding these facts, I, for myself and anyone acting on my behalf, waive, and release, the members of The Florida Track Club, and all other sponsors and their representatives from all claims and liabilities of any kind arising out of my participation of this event even though that liability might arise out of negligence or carelessness on the part of persons named in this waiver. I understand and agree to abide by the insurance restrictions, which prohibit the use of portable sound systems, wheel conveyances (excluding racing wheelchairs) but including skateboards, roller skates or blades, bicycles, etc. Illegible applications may result in disqualification. My entry in this race authorizes the Florida Track Club, organizations conducting races, or sponsors to record the race and its results in any medium and use those recordings in its discretion for any purpose. The Florida Track Club, organizers, or sponsors in no manner guarantee the accuracy of recording or reporting of results of any race.

 

_________________________________________                        _______________________

Signature of Participant                 Signature of parent or guardian if Participant is under 18


The Florida Track Club is a member of the Road Runners Club Of America and the USA Track and Field Florida Association.


    

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