Fit to Foster 5K Fun Run/Walk

Sunday September 27, 2015

Location: Hines Park, Nankin Mills Recreation Area

33175 Ann Arbor Trail, Westland, MI 48185

Time: 8:00am registration and 9:00am start

No Entry Fee

Packet Pick-up: Race site, starting at 8:00am

 Please Print and Fax Completed Form to: 313-852-1707 Attention: Jawana Kelly

Name________________________________________________________________________________________________________

Email:________________________________________________________

Phone:_______________________________________________________

Address:______________________________________________________________________________________________________

City/State/Zip_______________________________________________________________________________________________

Age_________                                  Gender: M  F                                                                                     Shirt Size:  XS  S  M  L  XL 2X

Waiver of Liability:

In consideration of you accepting this entry, I, the participant, intending to be legally bound and hereby waive or release any and all right and claims for damages or injuries that I may have against the Event Director, and all of their agents assisting with the event, sponsors and their representatives and employees for any and all injuries to me or my personal property. This release includes all injuries and/or damages suffered by me before, during or after the event. I recognize, intend and understand that this release is binding on my heirs, executors, administrators, or assignees.

I certify as a material condition to my being permitted to enter this race that I am physically fit and sufficiently trained for the completion of this event and that my physical condition has been verified by a licensed Medical Doctor. By submitting this entry, I acknowledge (or a parent or adult guardian for all children under 18 years) having read and agreed to the above waiver.

Signature:­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­______________________________________________  Date:____________________________________________