2015 UGLY CHRISTMAS SWEATER 5K RUN
2015 UGLY CHRISTMAS SWEATER 5K RUN YMCA of Tyler 903-593-7327 www.tylerymca.org Race Information Date: Time: Cost: Sept 1st-Nov 25th Cost: Nov 26th-Dec 5th Race-Day Reg Location: Race Director
Saturday, December 5, 2015 Race Starts @ 9:00PM $20 Adults, $15 Youth $25 Adults, $20 Youth 8:00am @ *YMCA of Tyler only* 225 South Vine Ave, Tyler, TX 75702 Email [email protected]
*Fees are nonrefundable
Register by November 25th and receive a souvenir race t-shirt Runner’s Name: ___________________________ Gender: ____ DOB: ___/___/___ Age (as of Dec 5): _____ Address: _____________________________________ City: _______________________Zip: ______________ Parent/Guardian’s Name: ________________________________ Parent/Guardian’s D.O.B.: ____/____/____ (If under 18) Primary Phone: ____________________________ Secondary Phone: _________________________________ Email Address: ______________________________________________________________________________ T-shirt size (Circle):
YS
YM
YL
AS
AM
AL
XL
2XL
3XL
I hereby certify that I am in normal health and capable of safe participation in this event. I assume all risks and hazards incidental to the conduct of this event and for the transportation to and from the event. I hereby authorize the YMCA to obtain medical treatment for me in the event that an injury occurs. By my own signature and my own free will, I do hereby agree to indemnify and save harmless the YMCA of Tyler, the City of Whitehouse, any sponsors, promoters, persons or entries associated with this event from any and all claims or demands, costs or expenses arising out of injuries, damages or other losses, whether personal or property, sustained by me or any party to whom I am responsible. I also understand any photography or film of my participation may be used for marketing and promotional materials without compensation
__________________________________________ Signature
___________________________________ Date
Saturday, December 5, 2015 Race Starts @ 9:00PM $20 Adults, $15 Youth $25 Adults, $20 Youth 8:00am @ *YMCA of Tyler only* 225 South Vine Ave, Tyler, TX 75702 Email [email protected]
*Fees are nonrefundable
Register by November 25th and receive a souvenir race t-shirt Runner’s Name: ___________________________ Gender: ____ DOB: ___/___/___ Age (as of Dec 5): _____ Address: _____________________________________ City: _______________________Zip: ______________ Parent/Guardian’s Name: ________________________________ Parent/Guardian’s D.O.B.: ____/____/____ (If under 18) Primary Phone: ____________________________ Secondary Phone: _________________________________ Email Address: ______________________________________________________________________________ T-shirt size (Circle):
YS
YM
YL
AS
AM
AL
XL
2XL
3XL
I hereby certify that I am in normal health and capable of safe participation in this event. I assume all risks and hazards incidental to the conduct of this event and for the transportation to and from the event. I hereby authorize the YMCA to obtain medical treatment for me in the event that an injury occurs. By my own signature and my own free will, I do hereby agree to indemnify and save harmless the YMCA of Tyler, the City of Whitehouse, any sponsors, promoters, persons or entries associated with this event from any and all claims or demands, costs or expenses arising out of injuries, damages or other losses, whether personal or property, sustained by me or any party to whom I am responsible. I also understand any photography or film of my participation may be used for marketing and promotional materials without compensation
__________________________________________ Signature
___________________________________ Date
