8th
annual Ozark Greenways Adventure Race – Saturday, May 19, 2007
Before or
on May 1: FREE
May 2 –
May 13: $15 per sub
May 14 –
May 18: No subs taken
Race Day
Subs: $30 per sub
Please
fill out this form completely, sign and mail or fax to:
Ozark
Greenways Adventure Race, P.O. Box 50733, Springfield MO 65805
(417)
864-1497 Fax
TEAM NAME:
__________________________________________________
TEAM
CAPTAIN: _______________________________________________
Team member being REPLACED:
_________________________________
Name of
NEW member: __________________________________________
Address:
__________________________________________________________
City/State/Zip:
______________________________________________________
Daytime phone #:
___________________________________________________
Evening
phone #: ___________________________________________________
Email address:
_____________________________________________________
Age on race
day: ___________
T-shirt size: _______________
Male: ____ Female: _____
Emergency contact (Full name):
________________________________________
Emergency
contact phone #: ___________________________________________
List any allergies or health
concerns: _____________________________________
SIGN WAIVER:
In
consideration of the acceptance of my entry, I, for myself, my heirs,
executors, and administrators, waive and release any and all rights and claims
for damages I have or may have against the organizers of the Ozark Greenways
Adventure Race (hereinafter referred to as “the event”), its principals, its
employees, its volunteers, all sponsors and/or promoters and their
representatives, and Ozark Greenways, Inc. (including its officers, employees,
members and volunteers), and any and all claims of damages, demands, actions
whatsoever in any manner as a result of my participation in the event,
including travel to and from the event. I attest and verify that I am
physically fit and have sufficiently trained for the competition of the event
and I have not been advised otherwise by a qualified medical person. I further
understand that serious accidents can occur during adventure racing, and that
participants in adventure racing occasionally sustain mortal or serious personal
injuries, and/or property damage, as a consequence thereof. Knowing the risks
of adventure racing, nevertheless, I hereby agree to assume those risks and to
release and hold harmless all of the persons and entities mentioned above who
might otherwise be liable to me. Finally, I further state that I have carefully
read the foregoing Release of Liability and know and understand the contents
thereof, and that I sign this Release of Liability as my own free ad.
Replacement
team member signature _______________________________________________
Date____________________