Apple Hill Blossom Trail Run Registration Form

 

Please make checks payable to and mail to Apple Hill Growers Association, P.O. Box 494, Camino, CA 95709

 

Name___________________________________

 

Address____________________________________City___________________

 

State______Zip________Gender__________ DOB__________

 

Email ______________________________________________

 

Shirt size: Adult: S  M  L  XL  XXL      Youth:  S  M  L

 

Upgrade to a moisture wicking shirt for an additional $12 before April 18th,    size:__________________

 

Distance:  5k walk (untimed)___________5K run___________          10K _____________    10 Mile_____________

 

 

The following release waiver must be signed by all participants

AGREEMENT, WAIVER & RELEASE

I, intending to be legally bound, for myself, my heirs, executors, administrators, waive and release any and all rights and claims I may have against J & J Sports Productions, Apple Hill Growers Association, their agents, promoters and sponsors, and all persons, officials and organizations affiliated with the event for any and all injuries suffered by me while traveling to and from and while competing in this J & J Sports Productions event. I further attest that I am physically fit and sufficiently trained for this event. I, also give my permission for the free use of my name and/or photographs in any broadcast, telecast, newsprint or any other account of this event. I acknowledge I have read and fully understand my own liability and do accept the restriction.  I have read and fully agree to the above

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SIGNATURE(parent/guardian if under 18)___________________________________________

Date:__________________