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ENTRY FORM PAGE 2
M A R AT H O N
TEAM RELAY
A P R I L 2 5 , 2 015 • L O U I S V I L L E , K Y
April 23-24
April 24
April 25
Race Expo & Packet Pick-Up
Running Wild® Pasta Dinner
Race Day Post Race Party
WELCOME
We are pleased to again offer the Marathon Team Relay in conjunction with the 2015 Kentucky Derby Festival Marathon/
miniMarathon®. This is an exciting way to show your organization’s or group’s true Festival spirit. Come represent
your organization or group and compete to display the Kentucky Derby Festival Marathon Team Relay trophy.
Kentucky Derby Festival Marathon Team Relay
Marathon Team Relay Entry Fee
Marathon Team Relay “Perks”
• Official relay medal and poster
• Team relay t-shirt
•Packet pick-up from 4 p.m. – 8 p.m., April 23rd and
11 a.m. – 9 p.m. April 24th, at the Kentucky International
Convention Center
• Special completion certificates for Team Relay participants
• 5-Person Team Relay Entry: $300.00
Marathon Team Relay Rules and Guidelines
•Each Team will consist of up to 5 runners. A Team can have as
few as three members competing; however, this will require that
some Team members run two consecutive legs. For example, if
a Team has only three members, the first runner may run the
first two legs of the relay and the second runner may run the
next two, while the third runs the final distance to the finish
line. If a Team has four members, one member must run two
consecutive legs of the relay.
•All Team members must be registered by the entry deadline of
March 31, 2015. (Note: Team Relay participants do not fill out
individual entry forms.)
•Participants can choose to compete on an “All Men’s Team,”
“All Women’s Team” or a “Coed Team.”
•Each Team will be given one velcro strap timing chip that will
be passed from Team member to Team member at each of the
relay exchange points. The Team timing chip with the best time
in each division will be declared the winner.
•The Relay Team members will run the same course as
the Marathon field, under the Ekiden format. See chart
to the right.
Team Relay Awards
•The Team Relay has “All Men’s Team,” “All Women’s Team”
and “Coed Team” Divisions
•Trophies will be awarded to the
top three (3) finishing Teams of each
Division in the Marathon Relay
Marathon Team Relay Registration
Mail-In Registration
• One Entry Form filled out for each Team
• Only one Team per entry form
• Entry Forms may be photocopied
•Entry Forms must have all information
complete and payment must accompany form
• Call 1-800-928-FEST for your Team Relay
Entry Form
•Mail the completed form and fees to:
Kentucky Derby Festival Marathon Team Relay
1001 S. Third Street
Louisville, KY 40203
For further information about
the Kentucky Derby Festival
Marathon Team Relay, please
call 1-800-928-FEST.
Leg
Miles
KM
First
6.21
10K
Second
3.10
5K
Third
6.21
10K
Fourth
3.10
5K
Fifth
7.58
12.2K
q All Women’s Team
Official Use Only
Race#
q Coed Team
Sex: M q F q
Official Use Only
Race#
Official Use Only
Race#
Date
Signature of Team Member
Male Technical Shirt Size:
Female Technical Shirt Size:
S q M q L q XL q XXL q
S q M q L q XL q XXL q
By my signature, I acknowledge that I have read, understand and agree to the Release, Indemnity
and Assumption Agreement.
(Hours, Minutes, Seconds)
q Yes, I want my free Pasta Dinner ticket
Sex: M q F q
State:Zip:
Age on Race Day:
TEAM MEMBER #3
Signature of Team Member
First Name:
Last Name:
Address:
City:
Phone Number:
E-mail Address (for race information only):
Birthdate:
Estimated Team Finish Time:
Date
Male Technical Shirt Size:
Female Technical Shirt Size:
S q M q L q XL q XXL q
S q M q L q XL q XXL q
By my signature, I acknowledge that I have read, understand and agree to the Release, Indemnity
and Assumption Agreement.
(Hours, Minutes, Seconds)
q Yes, I want my free Pasta Dinner ticket
Sex: M q F q
State:Zip:
Age on Race Day:
TEAM MEMBER #2
Signature of Team Member
First Name:
Last Name:
Address:
City:
Phone Number:
E-mail Address (for race information only):
Birthdate:
Estimated Team Finish Time:
Date
Male Technical Shirt Size:
Female Technical Shirt Size:
S q M q L q XL q XXL q
S q M q L q XL q XXL q
By my signature, I acknowledge that I have read, understand and agree to the Release, Indemnity
and Assumption Agreement.
(Hours, Minutes, Seconds)
q Yes, I want my free Pasta Dinner ticket
Age on Race Day:
State:Zip:
TEAM MEMBER #1 (Team Captain)
q All Men’s Team
First Name:
Last Name:
Address:
City:
Phone Number:
E-mail Address (for race information only):
Birthdate:
Estimated Team Finish Time:
Choose One:
Organization Name:
Official Use Only
Official Use Only
Race#
Date
Signature of Team Member
Male Technical Shirt Size:
Female Technical Shirt Size:
S q M q L q XL q XXL q
S q M q L q XL q XXL q
By my signature, I acknowledge that I have read, understand and agree to the Release, Indemnity
and Assumption Agreement.
(Hours, Minutes, Seconds)
q Yes, I want my free Pasta Dinner ticket
Sex: M q F q
State:Zip:
Age on Race Day:
TEAM MEMBER #5
Signature of Team Member
First Name:
Last Name:
Address:
City:
Phone Number:
E-mail Address (for race information only):
Birthdate:
Estimated Team Finish Time:
Date
Male Technical Shirt Size:
Female Technical Shirt Size:
S q M q L q XL q XXL q
S q M q L q XL q XXL q
By my signature, I acknowledge that I have read, understand and agree to the Release, Indemnity
and Assumption Agreement.
(Hours, Minutes, Seconds)
q Yes, I want my free Pasta Dinner ticket
Sex: M q F q
State:Zip:
Age on Race Day:
TEAM MEMBER #4
Race#
State:Zip:
Signature of Witness (required)
First Name:
Last Name:
Address:
City:
Phone Number:
E-mail Address (for race information only):
Birthdate:
Estimated Team Finish Time:
Date
First Name:
Last Name:
Address:
City:
Phone Number:
E-mail Address (for race information only):
TEAM CONTACT INFO (If different from team captain)
Team Name/Number:
Qty.
Price Each Total
WAIVER MUST BE SIGNED TO BE PROCESSED
$6.00
*No Refunds
Make check payable to: Kentucky Derby Festival, Inc.
* Total
Subtotal
sales tax included
Marathon Pin
Extras
Marathon Team Relay Entry (Includes a $5.00 paper processing fee.)$305.00
Description
DATE
SIGNATURE OF PARTICIPANT
WAIVER REQUIRED: I know that running a road race is a potentially hazardous activity. I should not enter to run unless I am medically able
and properly trained. I assume all risks associated with running this event, including but not limited to: falls, contact with other participants,
the effects of the weather, including high heat and/or humidity, traffic and the conditions of the road, all such risks being known and
appreciated by me. Having read this waiver and knowing these facts and in consideration of your accepting my entry to participate in the
Derby Festival Marathon / miniMarathon (hereinafter sometimes referred to as the Event) on Saturday, April 25, 2015 (or on such date as may
be determined in the event of a postponement of the Event) in Louisville, Kentucky, I intending to be legally bound, do hereby for myself, my
heirs, my executors and administrators agree as follows: 1. I do waive and forever release any and all rights and claims for any damages
and liabilities of any kind arising out of my participation in the Event against all persons, entities and agencies involved with promoting
the Event, including the Kentucky Derby Festival, Inc.; The Metropolitan Park and Recreation Board; Walmart; Asics; Norton Sports Health;
Louisville Water Company; Coca-Cola Enterprises; Bluegrass Family Health; Anheuser-Busch; The Courier Journal; Churchill Downs, Inc.;
Active.com; MINI of Louisville; Louisville Metro Government, its officials, executives, employees and agents; Fire Chief, Louisville Division of
Fire and their officials; State of Kentucky; and Waterfront Development Corp. their agents, successors, representatives and assigns even
though that liability may arise out of negligence or carelessness on the part of the persons named in the waiver. 2. Further, I assume the
risk of all bodily injuries including death, resulting therefrom and personal injuries to me and damage to and loss of my property, including
loss of use thereof and any other indirect or consequential damages, resulting directly or indirectly, wholly or in part, from my participation
in the Event and while traveling to and from the Event. 3. Further, I hereby agree to indemnify, defend and hold the entities specifically
named in paragraph numbered 1 above harmless from and against any and all claims, liabilities, losses, damages, costs, expenses, (including
attorney’s fees), judgments and penalties arising out of any of my acts or omission to act. 4. Further, in the event that the participant is a
person under 18 years of age, the undersigned parent or legal guardian of the participant agrees to indemnify, defend and hold harmless the
entities specifically named in paragraph numbered 1 above from and against any and all claims, liabilities, losses, damages, costs, expenses
(including attorneys fees), judgments and penalties arising out of the participant’s participation in the Event. 5. Further, I understand that
Kentucky Derby Festival, Inc. reserves the right to use any and all participant’s names and/or likenesses with regard to promotional and/
or advertising materials, including on the internet. 6. Further, I understand that all entries are nonrefundable and nontransferable. 7. Race
officials have the right to disqualify or remove from the course any participant whose activity violates any condition set forth or who poses any
potential harm to himself/herself or any other participant. 8. I am not signing this waiver on behalf of a participant who is under the age of 12.
POne
Includes a $5.00 paper processing fee.
All team information must be complete to register.
2015 Kentucky Derby Festival® Marathon Team Relay Official Entry Form