Run for Recovery 2009 Official Entry Form
Last Name ________________________________________________
First Name________________________________________________
Address ________________________________________________
City _____________________ State_____ Zip_________
Email: _________________________________________________
We will not, under any circumstance share your information with other companies.
____Male ____Female
Age on Race Day___________
Date of Birth_______________
Promo Code ______________
T-Shirt size (circle one)
Xlg Lg Med Sm Youth
Registration Fee
Postmarked by August 15th - $20.00,
After August 15th - $25.00
Race-day Registration - $30.00
1K Walk / Kid Run - $15.00
*Fees are non refundable*
Make checks payable to:
Run For Recovery
13241 Valley Branch Suite #100
Farmers Branch, TX 75234
Signature _____________________________________ Date____________________
By signing the above, I agree to the terms listed in the waiver statement below.
Waiver Statement: Entry invalid if unsigned. By signing I acknowledge that I am aware that running is a potentially dangerous
activity. I certify that I am physically fit, have sufficiently trained for this event, and have not been advised otherwise by a
qualified medical person. I also certify that I will drink plenty of water before, during, and after the event and that I will not
consume or be under the influence of any type of alcohol or illegal drug. I assume the risks of participation in this event
including, but not limited to, falls, contact with other participants, the effects of weather and the conditions of the track, all such
risks being known and appreciated by me. I assume full responsibility for injury, accident, or illness which may occur during the
event or while I am on the premises of the event and I hereby release and hold harmless the sponsors, promoters, and all persons
and entities associated with the event, from any and all injury or damage whether it be caused by negligence of the sponsors,
promoters or other persons or entities associated with this event or otherwise. I further grant my full permission to any and all
of the foregoing to use photographs, videotapes, motion pictures, recordings, or any other record of this event.