Rockaway Rotary 29th Annual Ocean Run

Sunday April 29th 10:00AM
5K and 1/4 Mile Children's Race

Print & Mail Application to: Rockaway Ocean Run, C/O Dr. Kiernan
115-06 Beach Channel Drive
Rockaway Park, NY 11694

Registration at Riis Park Golf Course
Post Race Party and Awards at the Riis Park Golf Course
Last Name: First:
Address:
City: State: Zip:
E-mail:
T-Shirt Size: M: L: XL:

Male Female      Age on Race Day:

Make Check payable to Rockaway Ocean Run
Entry Fees:
$20.00 Post Marked by April 23th
$23.00 Race Day
Children under 10 Years Old 1/4 mile race $8.00 Pre-registered

Waiver-General Release of Liability
I understand that running in the Rockaway Ocean Run Memorial Run is a potentially hazardous activity. I agree that I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely participate in the run. I assume all risks associated with participating in this event, including but not limited to falls contact with other participants, the effects of weather, traffic and road conditions. Having read this waiver and knowing these facts and in consideration of your acceptance of my application, I for myself and anyone entitled to act in my behalf, waive and release Cumberalnd Parking Corp, The Rockaway Rotray Club Inc, The Department of Parks and Recreation, and all sponsors, their representatives and successors from all claims and liabilities of any kind arising out of my participation in this event even though the liability may arise out of negligence or carelessness on the part of persons named in this waiver. I grant permission to all of the foregoing to use any photgraphs, motion pictures, recordings or any other record of this event to any legitimate purpose.

Signature: _________________________________________
Date: _____________
Hosted by www.Geocities.ws

1