NAME:___________________________________________________________________
ADDRESS:_______________________________________________________________
CITY, STATE, ZIP:_________________________________________________________
PHONE:___________________________ T-SHIRT SIZE (circle one): S M L XL
DATE OF BIRTH:_______________ AGE (on race day):_____ SEX (circle one): M F
E-MAIL:__________________________________________________________________
WAIVER: I know that running is a potentially hazardous activity. I should not enter and run unless I am medically able. In consideration of your accepting my entry, I assume all risks associated with running in this event including, but not limited to: falls, contact with 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, I hereby waive and release Historic Lincoln Lincoln Preservatioin Foundation, Inc., all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event. I grant permission to the foregoing to use any photographs, motion pictures or any other record of this event for any legitimate purpose.
Fee is $10 in advance or $12 race day. Make check payable to Historic Lincoln 5K.
Mail to: Historic Lincoln 5K; PO Box 528; Lincoln AL 35096
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