Indian Nation 5K - Biloxi Public Schools

Apr 29, 2017 - WAIVER: I know that running a road race is a potentially hazardous activity. I should not enter and run unless I am medically able and properly ...
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4thAnnual

Indian Nation 5K & 1 Mile Fun Run Saturday, April 29 • 9 a.m. Biloxi Town Green

Both races are open to the public, water available on course, drinks and snacks after race—costumes encouraged!

Pre-Race Registration

Late Registration (after Apr. 21)

•$12 Adults, $5 Students by Apr. 21

•$15 all entrants

•Check-In/Late Registration at 8 a.m.

•Must sign up by 8:30 a.m.

Registration forms also available online at www.biloxischools.net 1-MILE Prize Money, Male and Female 1st Place $100 • 2nd Place $50 • 3rd Place $25 5K Awards, Male and Female Cash prizes for Top 3 Overall • Medals for Top 3 in the following age groups: Elementary, Jr. Hi, HS, 20-29, 30-39, 40-49, 50-59, 60+

Name (one form per person):________________________________________________________________________ Sex:________ Race Day Age:_________ Phone:__________________________ BPS Employee? ______ Students, please circle student group: Elementary Jr. High High School Adults, please circle adult group: 20-29

30-39

40-49

50-59

60+

Students and employees, please circle your school: BHS BJHS Gorenflo Jeff Davis Nichols North Bay Popp’s Ferry All race participants will receive an Adidas sling backpack and a water bottle! WAIVER: I know that running a road race is a potentially hazardous activity. I should not enter and run unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the race. 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 heat and/or humidity , traffic and the 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 Biloxi Public Schools and all sponsors, their representatives and successors from all claims for liabilities of any kind arising out of my participating in this event. I grant permission to all of the foregoing to use any photographs, motion pictures, recording or any other record of this event for any legitimate purpose. And I agree that all decisions of the race committee are final.

Signature (parent sign if under 18)_______________________________________________________________________Date:________________________________ ALL FORMS MUST BE SIGNED, REGARDLESS OF AGE (PARENT SIGN FOR STUDENTS UNDER 18)

Make checks payable to: Biloxi High School Hardwood Club (checks are non-refundable) Return Form to School or Mail to: Indian Nation 5K, 160 St. Peter Street, Biloxi, MS 39530