pitt community college campus
RACE WAIVER I know that running a road race is a potentially hazardous activity. I should not enter and run 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 the Bulldog Run on Sunday April 12, 2015, including, but not limited to falls, contacts with other participants, the effects of the weather, including high heat and/or humidity, low temperature, traffic and conditions of the road, all risks being known and appreciated by me. Having read this release and knowing these facts and in consideration of your accepting my entry, I, for myself and anyone entitled to act in my behalf or on behalf of my estate, waive and release Pitt Community College, Pitt Community College Foundation, all sponsors of the race, agents, volunteers, and their successors and assigns of each and every of the above from all claims or liabilities of any kind arising out of my participation in the race even though the liability may arise out of negligence or carelessness on the part of the persons referred to in this waiver. I also grant permission for the use of any photographs, motion pictures, recording, or any other record of my participation in this event for any legitimate purpose. I understand that if the race is canceled because of circumstances beyond the control of Pitt Community College, Pitt Community College Foundation, the race committee, and sponsors, including, but not limited to unsafe weather conditions or governmental ban, my entry fee will not be refunded. present the BULLDOG RUN 5K & 1 Mile Fun Run SAFETY NOTICE For the safety of all the runners and fun run participants, we must prohibit bicycles, roller skates, roller blades, and all other wheeled vehicles (except wheelchairs) from the Bulldog Run. We also consider the use of headphones in running events to be a safety hazard, and we advise that headphones/earbuds be kept at a volume level to where the participant can hear race volunteers. Pets are not permitted. By signing below, I agree that I have read and understand the Race Waiver and Safety Notice. ________________________________________________________ Signature of Participant Date If under 18: _________________________________________________________ Authorization of Parent/Guardian Date SUNDAY, APRIL 12, 2015 . 4:00 PM PITT COMMUNITY COLLEGE CAMPUS BULLDOG RUN 5K & 1 Mile Fun Run On Sunday, April 12, 2015 the Pitt Community College Center for Student Activities is sponsoring a “Family Fun and Run Day” event to help fund travel, activities, and pinning ceremonies for student clubs and organizations. All race participants will receive FREE baseball tickets for the April 12 doubleheader games beginning at 12 pm, with activities beginning at 4pm. PCC Bulldog Run Registration Form You may also register online @ www.pccbulldogrun.com Name _________________________________________________________ Address ________________________________________________________ City ____________________________ State _______ Zip _____________ E-mail __________________________ Phone ________________________ Gender:MaleFemale T-shirt Size: (circle one) S Age on Day of Race __________ M L XL XXL Date of Birth __________________________ Sponsoring Club/Organization Sunday April 12, 2015 4:00 pm Pitt Community College Campus Lewis Field House Registration: 4:30 – 6:00 pm The 1 mile fun run and 5K will begin at 6:45 Age Categories for Both Sexes 15 & under 16-19 20-29 30-39 40-49 50-59 60-69 70 & over Prizes will be awarded to the overall 3 Male & Female winners as well as the top 3 Male & Female winners in each age group. All races will run through PCC campus on flat pavement. Chip scoring will be provided by Run the East. Event Entered and Fees: (circle desired race) 5K Road Race 1 Mile Fun Run $20.00 before April 1, 2015 $________ $25.00 April 1-12 till Race Day $________ $10.00$________ TOTAL ENCLOSED$________ Check one: check enclosed - made payable to PCC Foundation: Bulldog Run credit card (AMEX, MC, VISA) (online registration only) Card number ___________________________ Signature ______________________________ Mail form and payment to: PCC Student Act. c/o Katelynn J. PO Drawer 7007 Greenville, NC 27835 or fax to 252.321.4612 Expiration Date __________
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