Just print this page and mail to the address shown with your check for your entry fee.
I know that running is a potentially hazardous activity. I hereby certify that I am medically able and properly trained to complete this run. I assume all risk associated with this event, including but not limited to: falls, contact with other participants, the effects of the weather including hight heat and/or humidity, and any traffic or conditions of the roade. I, for myself and anyone entitled to act on my behalf, waive and release Hidden Valley Incorporated, Paradise Valley, LLC, the Paradise Valley RV Park Condominium Association, advertisers, officails, volunteers, the representatives and successors from claims or liabilities of any kind arising out of my particiaptieon in this event, though the liabilty may arise out of negligence or carelessness on the part of the person named in this waiver. I understand that entry fees are non-refundable and non-transferable.
Address: __________________________
__________________________________
__________________________________
Phone: ____________________________
Email: ____________________________
TShirt Size: S M L XL
Gender: M F
Age (On Race Day) ___________
Signature of parent or guardian if under 18 years of age: ________________________________________
Date: _______________
__________________________
Amt. Recd:
__________________________
Date Recd:
April 24th, 2010
10:00 a.m.
Early entry - $20; deadline: 4/12/2010
Regular entry - $25; after 4/12/2010
PV Member entry - $15
Paradise Valley Resort
49 Valley Drive
Dawsonville, GA 30534
Make Checks Payable to Paradise Valley
Phone: 706-265-6110
Fax: 706-265-1533
[email protected]
Event Email: [email protected]