Date: Saturday, June 25, 2016 Time: Race begins @ 8 a.m. Location: Marion Technical College 1467 Mount Vernon Ave. Marion, OH 43302 Registration: $30 includes race T-shirt Late registration will be a $35 entry and does not guarantee shirt Registration is due June 17 to guarantee race shirt Race day registration from 7-8 a.m. Please complete a registration form for each participant. Payment can be made to: Marion Technical College Nursing 5K Name: __________________________________ Age: _______ Shirt Size: S M L XL Address: ________________________________ City: ______________ State: _____ Zip: ____ Email: __________________________ Phone: _________________ LIABILITY WAIVER- READ BEFORE SIGNING I know that running a road race can be a potentially hazardous activity. I should not enter and run/walk this event unless I am medically able and properly trained. In consideration of my entry, I hereby release, discharge, and agree to hold free and harmless, any sponsors, officials or organizers of this event and each of them together with their successors, assigns, officers, agents and employees from any and all liability for injuries to property or person suffered by me as a result of my participation in this event. By execution of this waiver, I assume all risks associated with participation in this event. Signature (Guardian if under 18):___________________________________________________
Checks can be made out to: Marion Technical College Nursing 5k Mail Form and payment to: Marion Technical College, Attention to: Cindy Hartman 1467 Mount Vernon Ave., Marion, OH 43302
