RUN FOR THE NATIONS 5K & 10K

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Team name   First name   Last name   Email address   Date of birth    MM 01 02 03 04 05 06 07 08 09 10 11 12    DD 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31    YYYY 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919    Gender -- Male Female   Phone #   Address   Emergency contact name   Emergency phone #   Distance Choose one Virtual Runner 5K Men 5K Student 5K Women 10K Men 10K Student 10K Women   Event entry fee TBD

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Please review the waiver provided by the event organizer and click the check box below to accept it. Print waiver In consideration of being permitted to participate in First Baptist Church Lake Isabella's "Run For Nations", I agree to assume all risks inherent in participation in such program, whether they are apparent to me or not. I certify that I am in good physical health and fit to participate. Nevertheless, I acknowledge that participation carries an inherent risk of injury to my person and damage to my property. I hereby waive and release, for myself and for my heirs and assigns, any and all claims, causes of action, or liabilities which may hereafter accrue against First Baptist Church Lake Isabella, and its affiliates, their agents, employees, volunteers, officers, directors, successors and assigns, the County of Kern, The United States Forest Service, and any and all sponsors, their representatives and successors, that may arise as a result of my participation in First Baptist Church Lake Isabella's "Run For Nations", including any and all claims for personal injuries caused by First Baptist Church Lake Isabella's negligence. Further, I hereby grant full permission to any and all of the foregoing to use any photographs, motion pictures, recordings, or any other record of these events for any legitimate purpose, including commercial advertising, without monetary payment to me. (This information is protected by the Privacy Act). I accept the terms of the waiver