2008 APPLE BLOSSOM RACES ENTRY FORM

Please Print Clearly

Name:_________________________________________ Age:_______ Sex: Male_____ Female_____

Mailing Address:______________________________________ Phone:__________________________

City, State, Zip:__________________________________

Birthdate (month, day, year):_______________________

Circle race participating in: 5K 10K ½ Marathon 2K Fun Run

Circle Shirt Size: S M L XL XXL

Registration Fee: $20.00 for 5K or 10K ($27 after May 15)

$25.00 for ½ Marathon ($32 after May 15)

Registration for 2K Fun Run is free ($10.00 if participant wants a T-shirt). The 2K Fun Run is open to all ages but awards will only be given to ages 12 and under.

I’d like to help The Nature Center. Please accept my additional contribution of $____________

Credit Card No:______________________________________ Expiration Date_________

Check enclosed: Check number ____________ Total Amount ____________

Make checks payable to Carpenter Nature Center

Mail fee and entry form to: Carpenter Nature Center, 12805 St. Croix Trail, Hastings, MN 55033

WAIVER: 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 also know that although runner protection will be provided, there will be traffic on the course route. I assume the risk of running in traffic. I also assume any and all other risks associated with running this event including but not limited to falls, contact with other participants, the effects of weather, including high heat and/or humidity, and the conditions of the roads, all such risks being known and appreciated by me. I understand that the primary concern for race officials is the safety of all participants and volunteers, and if severe weather or a public emergency happens I will follow directions provided by race staff and public safety officials. Carpenter Nature Center reserves the right to cancel, delay or change the race to a non-scored run in case of extreme weather or other conditions affecting the safety of the participants.

Knowing these facts, and in consideration of your acceptance of my entry fee, I hereby for myself, heirs, executors, administrators or anyone else who might on my behalf, covenant not to sue, and waive, release, and discharge any organization associated with the race, and police, volunteers, any and all sponsors including their agents, employees, assigns or anyone acting on their behalf, from any and all claims or liability for death, personal injury or property damage of any kind or nature whatsoever arising out of, or in the course of, my participating in this event.

This Release and Waiver extends to all claims of every kind or nature whatsoever, foreseen or unforeseen, known or unknown.

The undersigned further grants full permission of this race and any organization conducting the race and/or agents authorized by them, to use any photographs, videotapes, motion pictures, recordings, or any other record of this event for any purpose.

Application for minors will be accepted only with a parent’s signature.

Signature_________________________________ Co-signature_________________________________

By parent or guardian; if applicant is under 18 years of age.