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Julie Run Registration Form June 22, 2013
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Number of participants:
First Name:
Last Name:
Date of Birth (MM/DD/YYYY):
Age (race day):
Sex:

   
Email Address:
Run Type:


   
Shirt Size:
   
For those registering online for the Annual Julie Run please read the waiver below and please respond below.

Waiver: I hereby waive all claims against Open Door Outreach Center, Inc., ROTPAC Racing LLC, Walled Lake Schools, sponsors, volunteers, employees and agents, municipalities, or any personnel, for any injury I may suffer in this event. I attest that I am physically fit and prepared for this event.

You must be over 18 years of age OR the parent/legal guardian of a minor under 18 years of age OR the legal guardian of an incapacitated and/or mentally challenged person in order to agree to the text above.
I agree to the waiver above:  
Signature: