GROUP REGISTRATION FORM 20% Discount given for groups ...
ENDURE takes place on Saturday, September 24, 2016 on the grounds of Sims Country Bar-B-Que located at 6160 Petra Mill Road, Granite Falls, NC 28630. The ENDURE event is to raise funds for missions affiliated with Dudley Shoals Baptist Church. Registration is available the day of the race, but space for the competitive heat of the Soldier Run cannot be guaranteed. (Competitive Heat of Soldier Run is limited to 75 participants.) Please note the Soldier Run is a race with obstacles in which runners will get dirty. NEW 2016 Soldier Run will be officially timed by Racing Toes Timing. To guarantee receipt of an event TShirt registration must be completed and received by September 15th, 2016.
GROUP REGISTRATION FORM 20% Discount given for groups of 10 or More—Use this form to register Mail form and payment to: Dudley Shoals Baptist Church, Attn: Melissa Sims 1882 Dudley Shoals Road, Granite Falls, NC 28630.
Print name
Male/Female
Age on race day
8:45 5K Trail run Chip timed ($20)
9:45 Jr Soldier Run (age 5-12 yrs. Old) ($15)
11:00 Soldier Run NonCompetitive ($25)
10:45 Soldier Run Competitive Chip timed ($25)
Combo 5K Trail run and Soldier run ($40)
Shirt size YL-Adult 3XL (add additional $2 for XL and larger)
Amount
Print name
Male/Female
Age on race day
8:45 5K Trail run Chip timed ($20)
10:00 Jr. Soldier Run ($15)
11:00 Soldier Run Noncompetitive ($25)
10:45 Soldier Run Competitive Chip timed ($25)
Combo 5K Trail run and Soldier run ($40)
Shirt size YL-Adult 3XL (add additional $2 for XL and larger)
Amount
Total Amount _______________ Less 20% discount _______________ Grand Total_______________ Packets may be picked up at Dudley Shoals Baptist Church on Friday, September 23rd from 5-7pm or on race day beginning at 7:30am and continuing through 10:15am. Please check-in at least 30 minutes prior to the start time for each race. Group Name: ________________________________________________________________________________________________________ Contact Name: _______________________________________ Email Address:_______________________________ Phone: _____________________ Mailing Address: ______________________________________City: ______________________________ State: __________ Zip: _________________ Method of payment: Cash _______ Check_______ Please make checks payable to ENDURE Account. Be sure to check us out on Facebook: www.facebook.com/EndureRace/Tyler Sims Memorial For more information please visit www.dudleyshoalsbc.com , email [email protected]. Therefore we also, since we are surrounded by so great a cloud of witnesses, let us lay aside every weight, and the sin which so easily ensnares us, and let us run with endurance the race that is set before us. Hebrews 12:1 GROUP LIABILITY FORM (all participants must sign)
Waiver: In consideration of the acceptance of my application for this entry, I, the undersigned intending to be legally bound, hereby, for myself and anyone acting on my behalf, release any and all claims for damages I may have against the event organizers, event supporters, directors, volunteers, and any sponsors and their representatives, successors and assignees for any and all injuries and death suffered by me in said event. I attest and verify that I know that an athletic event can be a potentially hazardous activity. I acknowledge that participating in this event is inherently dangerous. I fully realize the dangers of participating in this event, and fully assume the risk associated with such participation, including but not limited to the following dangers: dehydration, hyperthermia, hypothermia, hypernatremia, collision with pedestrians, vehicles, and other event participants and fixed or moving objects, dangers arising from other surface hazards, equipment failure, inadequate safety equipment, weather conditions, animals, the possibility of serious physical and/or mental trauma and injury, including death. However, I have sufficiently trained for the completion of this event and know that I am participating at my own risk. I understand that there are more hazards than are enumerated here, and that there are unknown and unforeseeable hazards. I engage in the activity of this event with knowledge of the inherent risks of injury. I understand the risks involved in this event and I have carefully read, understand and voluntarily accept the terms of this waiver and release agreement. In addition, I agree to abide by the rules and conditions laid down for the event and to follow instructions issued by event officials. I understand that circumstances beyond the control of the event director may cause the event to be modified, postponed or relocated. I accept that the organizers reserve the right to refuse entry from persons considered to have insufficient experience or disqualify those who fail to follow the rules and conditions. I agree that my name, voice or picture may be used by Dudley Shoals Baptist Church and race sponsors for promotional purposes. I affirm that the details written about me on this entry form are true. I agree it is my sole responsibility to be familiar with the course, the rules of the sanctioning body, and the special regulations of the event. I understand that there is a 2 hour time limit for completing this race, after which I will not expect the race organizers to remain at the finish area. I agree to notify the race organizers if I should decide to withdraw from this event prior to reaching the finish line. I have no physical or mental condition which, to my knowledge, would endanger myself or others if I participate in this event, or would interfere with my ability to participate in this event. I have read this waiver of liability and accept the risks and responsibility associated with entering this event. I further acknowledge that I may be required to sign an Acknowledgement Waiver & Release from Liability (AWRL) during the registration process prior to starting the race on the day of the event. I hereby grant permission for the free use of my name and picture in any broadcast brochure, website, or account of this event. I understand that by not pre-reregistering by the cut-off date listed on this form and online, I may not be able to get a souvenir T-shirt from this event. I have personally read this waiver of liability and accept the risks and responsibility associated with entering this event. All participants please sign below. If participant is under 18 years of age, parent or legal guardian must sign.
Print Name
Signature
Date
GROUP REGISTRATION FORM 20% Discount given for groups of 10 or More—Use this form to register Mail form and payment to: Dudley Shoals Baptist Church, Attn: Melissa Sims 1882 Dudley Shoals Road, Granite Falls, NC 28630.
Print name
Male/Female
Age on race day
8:45 5K Trail run Chip timed ($20)
9:45 Jr Soldier Run (age 5-12 yrs. Old) ($15)
11:00 Soldier Run NonCompetitive ($25)
10:45 Soldier Run Competitive Chip timed ($25)
Combo 5K Trail run and Soldier run ($40)
Shirt size YL-Adult 3XL (add additional $2 for XL and larger)
Amount
Print name
Male/Female
Age on race day
8:45 5K Trail run Chip timed ($20)
10:00 Jr. Soldier Run ($15)
11:00 Soldier Run Noncompetitive ($25)
10:45 Soldier Run Competitive Chip timed ($25)
Combo 5K Trail run and Soldier run ($40)
Shirt size YL-Adult 3XL (add additional $2 for XL and larger)
Amount
Total Amount _______________ Less 20% discount _______________ Grand Total_______________ Packets may be picked up at Dudley Shoals Baptist Church on Friday, September 23rd from 5-7pm or on race day beginning at 7:30am and continuing through 10:15am. Please check-in at least 30 minutes prior to the start time for each race. Group Name: ________________________________________________________________________________________________________ Contact Name: _______________________________________ Email Address:_______________________________ Phone: _____________________ Mailing Address: ______________________________________City: ______________________________ State: __________ Zip: _________________ Method of payment: Cash _______ Check_______ Please make checks payable to ENDURE Account. Be sure to check us out on Facebook: www.facebook.com/EndureRace/Tyler Sims Memorial For more information please visit www.dudleyshoalsbc.com , email [email protected]. Therefore we also, since we are surrounded by so great a cloud of witnesses, let us lay aside every weight, and the sin which so easily ensnares us, and let us run with endurance the race that is set before us. Hebrews 12:1 GROUP LIABILITY FORM (all participants must sign)
Waiver: In consideration of the acceptance of my application for this entry, I, the undersigned intending to be legally bound, hereby, for myself and anyone acting on my behalf, release any and all claims for damages I may have against the event organizers, event supporters, directors, volunteers, and any sponsors and their representatives, successors and assignees for any and all injuries and death suffered by me in said event. I attest and verify that I know that an athletic event can be a potentially hazardous activity. I acknowledge that participating in this event is inherently dangerous. I fully realize the dangers of participating in this event, and fully assume the risk associated with such participation, including but not limited to the following dangers: dehydration, hyperthermia, hypothermia, hypernatremia, collision with pedestrians, vehicles, and other event participants and fixed or moving objects, dangers arising from other surface hazards, equipment failure, inadequate safety equipment, weather conditions, animals, the possibility of serious physical and/or mental trauma and injury, including death. However, I have sufficiently trained for the completion of this event and know that I am participating at my own risk. I understand that there are more hazards than are enumerated here, and that there are unknown and unforeseeable hazards. I engage in the activity of this event with knowledge of the inherent risks of injury. I understand the risks involved in this event and I have carefully read, understand and voluntarily accept the terms of this waiver and release agreement. In addition, I agree to abide by the rules and conditions laid down for the event and to follow instructions issued by event officials. I understand that circumstances beyond the control of the event director may cause the event to be modified, postponed or relocated. I accept that the organizers reserve the right to refuse entry from persons considered to have insufficient experience or disqualify those who fail to follow the rules and conditions. I agree that my name, voice or picture may be used by Dudley Shoals Baptist Church and race sponsors for promotional purposes. I affirm that the details written about me on this entry form are true. I agree it is my sole responsibility to be familiar with the course, the rules of the sanctioning body, and the special regulations of the event. I understand that there is a 2 hour time limit for completing this race, after which I will not expect the race organizers to remain at the finish area. I agree to notify the race organizers if I should decide to withdraw from this event prior to reaching the finish line. I have no physical or mental condition which, to my knowledge, would endanger myself or others if I participate in this event, or would interfere with my ability to participate in this event. I have read this waiver of liability and accept the risks and responsibility associated with entering this event. I further acknowledge that I may be required to sign an Acknowledgement Waiver & Release from Liability (AWRL) during the registration process prior to starting the race on the day of the event. I hereby grant permission for the free use of my name and picture in any broadcast brochure, website, or account of this event. I understand that by not pre-reregistering by the cut-off date listed on this form and online, I may not be able to get a souvenir T-shirt from this event. I have personally read this waiver of liability and accept the risks and responsibility associated with entering this event. All participants please sign below. If participant is under 18 years of age, parent or legal guardian must sign.
Print Name
Signature
Date
