ENTRY FORM (For officials) Race#_____
Name _____________________________ Age on Race Day _______ Date of Birth ___________
Address ___________________________________ Phone number ______________
City/State/Zip _________________________ *email please ________________________
Male ___ Female ___
RUN FOR FUN CHALLENGE Yes_____No_____
5K T-Shirt size: Youth Med___ Youth L ____ Adult S____ Adult M____ Adult L____ Adult XL____
Preregister by May 31 to guarantee t-shirt on race day
$20 before June 1 #___ $_____________
$25 June 2 and on race day #___ $_____________
$10 Youth 1/2 mile T-shirt - Optional #____ $_____________
Fun Run Free #____ $FREE
Some fees apply when registering online.
Make check out to: LF Chamber of Commerce
Send check to: River Rat Run 10904 Harvest Rd., Little Falls, MN 56345
For more information please call: Jacki Devine 320-632-5796
Waiver of Liability: ALL ENTRY FEES ARE NONREFUNDABLE.
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 run. I assume all risks associated with participating in this event including, but not limited to falls, contact with other participants or spectators, the effects of the weather – including extreme cold or warm temperatures, the conditions of the road surface, all such risks being known and appreciated to 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 for my behalf, waive and release the River Rat Run, the management personnel, and all sponsors of the event, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event even though that liability might arise out of negligence or carelessness on the part of the persons named in this waiver.
I hereby consent to and authorize the use and reproduction, in print or electronic format by the River Rat Run or anyone authorized by the River Rat Run, of any and all photographs which have been taken on this day for any publicity purposes without compensation. All images – electronic, negatives and positives, together with the prints – are owned by River Rat Run. I hereby acknowledge that I have read and understand the terms of this release. If you are under age 18, parent or guardian must sign entry form.
Signature of Participant ______________________________ Date _________________
Signature of guardian if under 18 _______________________