Saturday, November 8th, 2008

First, type in the following information on your computer,
then print the form, sign it and mail it in with your payment.
 to
Baz Hawley, RD
73-R Calle Aragon
Laguna Woods, CA 92637

               Marathon---$50 (if postmarked by Nov 1st, $70 thereafter)

        Name:  

     Address:  

        City:  

       State:     Zip:    Sex: M F  
         T-Shirt Size: Small  Medium  Large  X-Large

   Bus Phone:         Date of Birth:  

  Home Phone:         Age on race date: 

  E-mail address: 

WAIVER OF LIABILITY

In consideration of your accepting this entry, I, the here signed, intending to be legally bound hereby for myself, 

my heirs, executors and administrators, waive and release any and all rights and claims for damages that I may 

have against race director, volunteers, USATF, all sponsors and their representatives, successors, and assigns for 

any and all injuries suffered by me in said event.  I verify that I am physically fit and have sufficiently trained for 

the completion of this event and my physical condition has been verified by a licensed medical doctor.

_______________________________  _____________ _____________________________________

Signature                        Date          Parent's Signature if under 18