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Rolling Hills Classic
  ROLLING HILLS CLASSIC ENTRY FORM

ROLLING HILLS CLASSIC ENTRY FORM

Information

Information

Date: Saturday, September 15, 2012 - This event has been cancelled for 2012!

Location: Madison Middle School
Rexburg, Idaho

Course: The 10K will start at Madison Middle School and run on Yellowstone to University drive, then left to 7th South, the East to 2nd East, south to Pole Line road, then turn around and back to 7th south and back to the Middle School.
The 5K will start at Madison Middle School and run on Yellowstone to University drive, then left to 7th South, the East to the corner of BYU-Idaho Campus and turn around and down 7th south to the Middle School.
Start Time: 9:00 am
Registration: 7:45am-8:45am
Awards & Raffle after the race!

This is a fundraiser for Make-A-Wish so encourage all you know to come participate in the fun.

1.  First Name

1. First Name


2.  Last Name

2. Last Name


3.  Address

3. Address


4.  City

4. City


5.  State

5. State


6.  Zip

6. Zip


7.  Phone number

7. Phone number


8.  Email Address

8. Email Address


9.  Birth Date

9. Birth Date


10.  Race Day Age

10. Race Day Age


11.  Gender

11. Gender


16.  BY SUBMITTING THE FORM YOU AGREE TO THE FOLLOWING LIABILITY WAIVER.

16. BY SUBMITTING THE FORM YOU AGREE TO THE FOLLOWING LIABILITY WAIVER.

I know that participating in a walking, jogging, running, event is a potentially hazardous activity and that I should not enter and complete 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 participating in this event including, but not limited to: falls, contact with other participants and wildlife, the effects of the weather, including heat, cold and/ or rain or snow, traffic and the conditions of the road, path, or trail, all such risks being known and appreciated by me. By adding the initials B.I.G. to my name I enter a special drawing. Having read this waiver and knowing these facts and in consideration of your accepting my entry, I, for myself and anyone
entitled to act on my behalf, waive and release the organizers of the selected event or events, the State of Idaho, all cities and counties, Butt In Gear, and all other sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event or carelessness on the part of the persons named in this waiver. Further, I grant permission to all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this event for legitimate purposes.