Register on-line via www.pvtc.org or register by mail
Send this form and your check to PVTC, 611 South Ivy Street, Arlington VA 22204
To register students up to 8th grade (free), you may fax your entry to 703-521-6157
Name ___________________________________ Phone ________________________ Age _______ M/F ____
Address ________________________________ City, State, ZIP __________________________________
E-mail ________________________________________________________________ Date of Birth ___-___-______
[_] Free (Students up to 8th grade)
[_] $3 per meet x__ meets (high school students)
[_] $4 per meet x__ meets (DCRRC or PVTC members)
[_] $5 per meet x__ meets (all others)
[_] To help keep these meets free for children, here is a donation of $ ______ . Total enclosed: $ ______
[_] I will help as a volunteer. Please call me. WE NEED TIMERS FOR 55-METER - 8 am to 9 am
For more info about volunteering, see http://pvtc.org/timers.htm or e-mail RACEDIRECTOR@ATT.NET
I know running a 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 relevant to my ability to safely complete this event.
I assume all risks associated with running in this event, including, but
not limited to: falls, contact with other participants, effects of the
weather, including high heat and/or humidity, and conditions of the course,
all such risks being known and appreciated by me. 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 all sponsors, including Arlington County VA, their elected
and appointed officials and employees, DC Road Runners Club, Potomac Valley
Track Club, RRCA, USATF, Runners World Magazine, their officers, directors,
agents, and employees, and all officials of this event from all claims
or liabilities of any kind arising out of my participation in this event
even though that liability may arise out of negligence or carelessness
on the part of the persons named in this waiver.
I understand this event is conducted under the regulations of Arlington County VA. I agree to release
my name and photo for publicity purposes. I understand that my name
and address will be provided to the sponsors of this event, including Runner's
World magazine. Parent or guardian must sign for
children under 18.
Signature (Parent or Guardian if under 18) __________________________________________
Date ______________
Indoor Meets in the Potomac Valley Region:
