Winter Race Series Entry 2014-2015

First Name __________________ Last Name_______________________

Address _________________________________________

City _____________________________ Zip ___________

Phone (_____)_________________________

Age ________ (as of December 7, 2014)

Male .........Female (circle one)

Family or Team Member? Yes_______ No _________

If Yes, Name Family/Team ______________________________________________________

HCR members: Individuals: $10 for series or $3 per race - Families/Teams (3 or more): $25 for series, $8 for single race
NON HCR members: Individuals: $25 for the series or $7 per race - Families/Teams (3 or more): $40 for series, $15 for single race

HCR Runners Club Membership Enclosed (link to membership form)

New - Renewal (optional) $____________ $15.00/year

Total money enclosed $ ____________

Return this section to:

HCR's Club Winter Race Series
P.O.Box 1511
Yakima, Washington

RELEASE. I know that running a road race is potentially hazardous activity. I should not enter and run unless I am medically able and property trained. I agree to abide by any
decision of a race official relative to my ability to safely complete the run. I assume all risks associated with running in this event including, but not limited to: falls, contact with other participants, the effects of the weather, including high heat and/or humidity, traffic conditions of the road, all such risks being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of your accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release the Hard Core Runners Club, its officers and agents, the American Association of Running Clubs, the City and County of Yakima and any and all participating race sponsors and the
director, officers, employees and agents of such parties, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I understand that bicycles, skateboards, baby joggers, roller skates or inline skates, animals and radio headsets are not allowed in the race and I will abide by this guideline.


_________________________________ __________________

Participants Signature ........................................Date

_________________________________ __________________

Parent or guardian if participant is under 18 .................Date



Frank Purdy @ 961-9769/