Sunday, April 5, 2009

First Name _______________________ Last Name _____________________________
Date of Birth __/__/____ Age on 04/05/09 __________ Sex M__ F __
Address _____________________________________ City ________State ____Zip _______
Personal ChampionChip # (If you own one)_________Race Day Emergency Phone # _____________
Email _________________________________________________

T-Shirt Size XS S M L - XL XXL

I will participate in: Marathon Half Marathon 5k

Packet Pick-Up: (4/2/2008 - 4/4/2009) Run-On Dallas Run-On Richardson Run-On Coppell Run-On McKinney Race Day at the event

WAIVER STATEMENT: Entry invalid if not signed.
In consideration of the acceptance of this registration entry and being permitted to participate in this event, I, the undersigned, assume full and complete responsibility for any injury or accident, which may occur during my participation in the event or while I am on the premises of the event. I hereby release and hold harmless and covenant not to file suit against the sponsors, promoters, contributors, municipalities, beneficiaries and all other persons and entities associated with the event-including but not limited to Mellew Productions, or their agents or employees from any loss, liability, or claims and any and all injury or damage whether such injury or damage be caused by the negligence, gross negligence, or misrepresentation of such parties or any other person or entity associated directly or indirectly with the event or their agents or employees and are not responsible for intentional, reckless, or negligent acts of third parties who are outside their control. I will not enter and participate unless medically and properly trained. I also know that although police protection will be provided, there may be traffic on the course route. I assume the risk associated with this event, including but not limited to falls, contact with participants, alcohol consumption, the effects of weather including high heat and/or humidity, and the conditions of the course, all such risks being known and appreciated by me. I further grant my permission to The Big D Texas Marathon to use any photographs, videotape, motion pictures, recordings, or any other record of this event.T-shirt size is not guaranteed. Fees are non-refundable. I have read the foregoing and certify my agreement by my signature below, and my parent's/guardian's signature if under 18.
Signature: X ____________________________________________ Date: _________________
Parent or Legal Guardian Signature, for minor: X ________________________ Date: ________

Mail application with check or money order payable to Mellew Productions at:
The Big D Texas marathon
P.O. Box 852856
Richardson, TX 75085