Kennedy Creek Chum Run

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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 2019 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    Gender -- Male Female   Distance Choose one 1/2 Marathon 5k 10k   Category Choose one Adult Youth Choose one Adult Youth Choose one Adult Youth   Event entry fee increases after January 22, 2020 Event entry fee TBD

Phone number  *   Street Address  *   City  *   State/Province  *   Zip Code  *   Country  *   Emergency contact name  *   Emergency contact phone #  *   Choose T-shirt size  * Please choose one: Women's Small Women's Medium Women's Large Women's XL Unisex Small Unisex Medium Unisex Large Unisex XL Unisex XXL   Would you like to receive e-newsletters about future Northwest Trail Runs events? Yes, please No, thank you I'm already signed up! Would you like to receive information about South Puget Sound Salmon Enhancement Group? Yes, please No, thank you I'm already signed up! Would you like to make an additional donation to the South Puget Sound Salmon Enhancement Group for the Kennedy Creek Salmon Trail? NoYes USD Would you like to receive an acknowledgement letter for the tax-deductible additional donation? No, thank you Yes, please How did you hear about this event?  * Please choose one: A friend or other runner Social media Online calendar or web search Poster, brochure, or advertisement I've run Northwest Trail Runs events before Another organization or group Other (please specify)   If you chose "Other", please describe:

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Please review the waiver provided by the event organizer and click the check box below to accept it. Print waiver Liability Waiver & Photo Release I know that trail running is potentially dangerous. The dangers include but are not limited to falling; colliding with other persons, vehicles, or animals; known or unknown medical conditions; effects of the weather; and conditions of the trails and roads. I alone am responsible for my safety while I participate I should not participate in trail runs unless I am medically able and properly trained. I have read & understood this waiver, & in consideration of acceptance of my application for this event, I, for myself & anyone entitled to act on my behalf, waive & release Meridian Geographics, LLC, South Puget Sound Salmon Enhancement Group, Green Diamond Resource Company, Taylor Timber Investment Company, USA Track & Field, event sponsors, City of Shelton, Thurston County, Mason County, the State of Washington, the United States of America, & any & all land owners & land managers, their representatives & successors, from all claims or liabilities of any kind arising out of my participation in this run, even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I grant permission to Meridian Geographics, LLC to use photographs or audio/video recordings of me for any legitimate purpose without compensating or further notifying me. I agree to the refund policy. I understand that my name, age, and gender will appear in the results on the web. I accept the terms of the waiver