BOSS Mentality Crossfit 5K Fun Run/Walk
All proceeds to benefit Canyon Rim Rotary Toy Fund
Fee $20 or 1-unwrapped new toy
All checks should be made to: Canyon Rim Rotary Foundation Memo: Toy Fund
Race Details:
Race starts at 8am. Registration 7:30 468 Central Avenue Oak Hill, WV parking available across the street For more information, email: bossmentalitycrossfit@gmail.com
Name:
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First & Last
Phone Number
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Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
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Age on Race Day
Gender
Male
Female
Participating In
5K Fun Run
3K Walk
Informed Consent Acknowledgement
I know that participation in this event is a potentially hazardous activity. I will not enter and participate unless I am medically able and properly trained. I assume all risks associated with this event, including but not limited to falls, contact with other participants, effects of weather, and the condition of the road. Having read this waiver and knowing these facts, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless BOSS Mentality Crossfit and all its respective officers, agents, and representatives from any and all liability for injuries to arising out of traveling to, participating in, or returning from 5K Fun Run.In case of injury to, I hereby waive all claimsagainst BOSS Mentality Crossfit, including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.
I grant permission to all of the foregoing to use any photographs, motion pictures pictures, recordings or any other record of this event for any legitimate purposes.
Confirmation
By agreeing above and submitting this form, I am delivering an electronic signature that is equivalent to an original manual paper signature. The electronic signature will be equally as binding as an original manual paper signature.
Digital Signature
Parent's Signature if athlete is under 18.
Submit Form
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