THE PURPLE Sponsored by: RUN 5K Benefiting the American Cancer Society Relay For Life of Lamar County Date: Saturday, May 30th 2015 Place: Vernon City Complex Time: Registration @ 7:00 AM, Walk/Run begins @ 8:00 AM 5K Fee: $20 Participant Name: _____________________________________________________ Gender: Male / Female Birth Date: _____________ Age on Race Day: _________ Email: _______________________________________________________________ Phone: ______________________________________________________________ Address: _____________________________________________________________ City: ___________________________ State: ______ Zip: ______________________ T-Shirt Size: XS S M L XL 2X Check one: Cash _______ Check _______ Turn in completed registration form and money to any of the following: Charles Stanford (205)-6958383; Tammy Huff at Goodwyn Mills & Cawood (Across from Jacks) in Vernon; Dickie or Celeste Dees (662)-574-7502; Bethany Huff (205)-712-0142. WAIVER: I know that running is a potentially hazardous activity. I should not enter this event 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 running in this race including, but not limited to, falls, contact with other participants, the effects of weather, including high heat and/or humidity, the conditions of the road and traffic on the course, all such risks being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of Relay For Life of Lamar County and Corinth Baptist Church accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release the American Cancer Society, Relay For Life of Lamar County, Corinth Baptist Church, The City of Vernon and the volunteers from all claims or liabilities of any kind arising out of my participation in this event. Furthermore, I agree to be bound by the rules established with respect to this event. In addition, I understand that if the race is canceled by circumstances beyond the control of the organizers, my entry fee will not be refunded. Participant Signature: ____________________________________ Date: _______________________ Legal Guardian Signature (If under 18): ________________________________ Date: ____________