2nd Annual Warrior Mud Run - Waccamaw High School Athletics

2nd Annual Warrior Mud Run
Saturday, June 20, 2015
Waccamaw High School, Pawleys Island, SC
www.waccamawathletics.com/warriorrun
All proceeds benefit the WHS Athletic Booster Club
APPLICATION
PAWLEYS ISLAND, SC
PRICING Individual
Team of 4
Kids 10-13
4/28-5/31
$40
$140
$25
6/1-6/19
$50
$180
$25
Race Day
$60
$220
$25
JUNE 20, 2015
START TIME 9:00 a.m. All Individuals
9:30 a.m. Male Teams
PACKET PICKUP
10:00 a.m. Co-Ed Teams
Friday, June 19..........4:00-7:00 pm
10:30 a.m. Female Teams
Moe’s BBQ - 1287 Ocean Hwy
Entry Fee Non Refundable 11:00 a.m. Kids Race
Pawleys Island
Saturday, June 20.....7:30-8:30 am
ON-LINE REGISTRATION active.com (registrant pays active.com fee)
Start/Finish Line
or MAIL CHECK AND ENTRY FORM TO
SHIRTS
Waccamaw High School Athletic Booster Club Shirts are guaranteed to early registration participants entry forms and
P.O. Box 1491, Pawleys Island, SC 29585
fees received by midnight May 31, 2015.
email: whsboosterclubsc@gmail.com
Every finishing participant guaranteed a medal if registered by May 31
Warrior Run Entry Form
Check One
o Individual
o Kids Race
o TEAM/Male o TEAM/Co-Ed o TEAM/Female
Individual or Kids
Name______________________________________________________________ Sex o Male o Female Birth Date__________________
Address __________________________________________________________________________________________________________
City _______________________________________________________________________ State_________ Zip Code_________________
Phone_____________________________________ Email__________________________________________________________________
Unisex Shirt Size circle one Adult S
M L
XL
XXL
Youth
M L Team Name______________________________________________________________________________________________________
Team Captain/Teammate 1__________________________________________ Sex o Male o Female Birth Date__________________
(The Team Captain will be responsible for receiving all correspondence for their team)
Address __________________________________________________________________________________________________________
City _______________________________________________________________________ State_________ Zip Code_________________
Phone_____________________________________ Email__________________________________________________________________
Unisex Shirt Size circle one Adult S
M L
XL
XXL
Youth
M L Teammate 2 _______________________________________________________Sex o Male o Female Birth Date__________________
Email__________________________________________________________________
Unisex Shirt Size circle one Adult S
M L
XL
XXL
Youth
M L Teammate 3_______________________________________________________ Sex o Male o Female Birth Date__________________
Email__________________________________________________________________
Unisex Shirt Size circle one Adult S
M L
XL
XXL
Youth
M L Teammate 4_______________________________________________________ Sex o Male o Female Birth Date__________________
Email__________________________________________________________________
Unisex Shirt Size circle one Adult S
M L
XL
XXL
Youth
M L ASSUMPTION OF RISKS, RELEASE OF liability AND PHOTO RELEASE: In consideration if being allowed to participate, I myself and any minor children for whom I am a parent, legal guardian, or otherwise, and
for my heirs, and assigns, hereby acknowledge and assume all risks involved in participating in this event and release the sponsors, race workers, officials and volunteers of the race from any and all liability arising
from injury, illness and damages (including death) I, or my family and /or group participants for whom I am a representative may suffer as a result of participation in such an event. I understand that this activity
may create physical stress resulting in possible harmful effects and I agree that I am, and my family and/or group participants whom I am a representative are, physically fit and sufficiently trained to participate
in the event. I understand that the entry fee is non-refundable. I give permission for free use of my, or my family and/or group participants for whom I am a representative, name and picture in any broadcast
or written accounts of the event. If race officials deem medical attention is necessary due to injury or illness, I, Or my family or group participants for whom I am a representative consent to be removed from the
course and treated by medical personnel of their direction I have read this assumption of risk and release of liability and understand that by signing this document, I, and my family and/or group participants for
whom I am a representative, are waiving valuable legal rights I, or we, have in conjunction with this event.
I hereby voluntarily grant the Georgetown County School District, Waccamaw High School and the Waccamaw High School Athletic Booster Club, its agents or assigns, permission to use any and all photographs
of me for purposes of reproduction in any form, but not limited or advertising, illustration, newspaper stories, television or radio broadcast or other publication.
Each member will be required to sign release waiver at packet pickup.