Falling Footsteps Application.pdf

Original file name: Falling Footsteps Application.pdf
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We Will Have: Glasses to Registrants Prizes for Age Groups RSCC Falling Footsteps Falling Footsteps The Richfield Springs Community Center cordially invites you to participate in the annual Falling Footsteps 5K Minimudder. Part of the proceeds will benefit the Youth Basketball Hoop Fund. Route 20 Series: : Go to www.nyroute20.com THANK YOU TO OUR SPONSORS! Application Name:__________________ Age ______ * Sex: M F (Circle One) (on 9/13/15) Address___________________________ ________________________________ Amount _______ e-mail ____________________________ WAIVER In consideration of acceptance of this application, I, the undersigned, intending to be legally bound, hereby, for myself, my heirs, executors, administrators, and assigns waive any and all rights and claims for damages I may have against the Richfield Springs Community Center, their representatives and successors for any and all injuries suffered by me at the races to be held in Richfield Springs, on Sept. 13, 2015. I verify that I am physically fit and have trained sufficiently for the competition. Signature __________________________


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