Fleet Feet Baltimore 2016 - Next Steps Program Form

 

5mil - 10K Training Program – 2016
RUN/WALK AND WALKING OPTION 

Registration Form
Fee $85.00

(Must Be 18 years old to Register without parent attendance)

 

First Name: _____________________________  Last Name:_______________________________

CELL Phone:__________________________  Tee Shirt Size: __________ RUN/WALK __  WALK __

Email (please write clearly):__________________________________________________________

*We must have your email address in order to communicate with you about program information!

Gender:_________  Date of Birth:______________  Age: ___________

Emergency Contact: ______________________________Emergency Phone #:____________

Refund Policy:
There will be no refunds given after first sessions when schedules are handed out.  I understand that adverse weather conditions are a possibility and are out of the control of the Fleet Feet Sports Baltimore training program.  I understand this class may be cancelled due to adverse weather conditions, including weather service alerts for dangerous air quality.  I understand that no refunds or make-up sessions will be given in the event of cancellation for adverse weather conditions.

________ By placing my initials here, I understand and agree to the terms of this policy.

Waiver:
In consideration of the foregoing, I, for myself, my heirs, executers, administrators, personal representatives, successors and assigns, waive and release any and all rights, claims, and causes of action I have or may have against the Fleet Feet Sports and its affiliates, their agents, employees, volunteers, officers, directors, successors and assigns, Fleet Feet Sports Baltimore, and any and all sponsors, their representatives and successors, that may arise as a result of my participation in the 2016 5MI/10K Training program and any pre- and post race activities.  I attest and verify that I am physically fit and a licensed medical doctor has verified my physical condition.  Further, I hereby grant full permission to any and all of the foregoing to use any photographs, motion pictures, recordings or any other record of this event for any legitimate purpose, including commercial advertising without monetary payment to me.

(This information is protected by the Privacy Act.)

 

Signature:_________________________________________________  Date:___________________

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EMPLOYEE USE ONLY:
Employee Initials: _______________________________ Date Paid:_______________

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