38TH MELON RUN JULY 4TH 2016!
July 4th: 3 mile @ 8:00 a.m., 1 mile Kids Fun Run @ 9:00 a.m.
If mailing in entry please send this form to:
Florida Track Club (Melon Run)
c/o Betsy Suda
4190 NW 50th Drive, #7305
Gainesville, FL 32606
Mail in entry deadline: June 30th Day of registration will close @7:30 a.m.
Last Name ___________________________________________ First Name _________________________________
Gender (check one): oM oF Age (race day) __________________________________
Address _________________________________________City/State/Zip ___________________________________
E-mail Address ______________________________________ T-Shirt Size oS oM oL oXL
(check one)
Contact phone number _____________________________________________
I am participating in the (check one): o3-Mile Melon Run o1-Mile Fun Run
FTC Member? oYES oNO
Interested in joining the Florida Track Club ($20/year)? See the benefits at www.floridatrackclub.wildapricot.org
Early registration $25 ($20 FTC) Race day $30 ($25 FTC)
Total enclosed $ ____________
Kids under 12, $5 (no shirt)
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