1st Annual Flight of the Eagle 5K Liberty High School Booster Club May 2, 2015, 7:30 AM at Liberty High School Packet Pick Up at Liberty High School Friday, May 1 from 3:00 PM to 7:00 PM Registration Form One registration form is required per participant. I plan to: ____Run ____Walk Last Name______________________________ First Name Address City___________________________ State________ Zip Phone__________________________ Email Date of Birth _____ / _____ / __________ Gender T-Shirts will be provided to all runners registered by Friday, April 24. Available sizes: YOUTH: S Entry Fee: $20.00 M L ADULT: S M L XL XXL (Circle one) Make checks payable to: Liberty High School Booster Club Waiver: In consideration of this entry, being accepted, I hereby for myself waive and release any claims that I may have against sponsors involved in the Flight of the Eagle 5K. I certify that I am physically able to participate in this event and have properly trained. I agree to abide by any decision of the race official relative to my ability to safely complete this event. I assume all risks associated with running in this event including but not limited to falls, contact with other participants, and the effects of weather including heat, 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 in consideration of you accepting my entry, I, for myself and anyone entitled to act in my behalf, waive and release Liberty High School Booster Club, Wentzville School District, and all sponsors, their representative and successors from all claims or liabilities of any kind arising out of my participation in this event. Print Name_____________________________________________ Date Signature (Parent/Legal Guardian must sign if participant is under the age of 18) Send your completed registration form and entry fee to: Liberty High School Booster Club Attn: Flight of the Eagle 5K 2275 Sommers Road Lake St. Louis, MO 63367