Shannon McNamara Registration Form 2013 (1).pdf
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Transcript of Shannon McNamara Registration Form 2013 (1).pdf
Additional$5.00feeforracedayregistration.
October 27, 2013
9:00 am Run
9:05 am Walk
400M Kids Race (free)
(10 and Under) after run/walk completion)
$15 ADULTS
$6 HS STUDENTS & YOUNGER
Name_______________________________________________________Age________________
CHECKONEBOX:_________________________
Compe,,veMaleCompe,,veFemaleWalkerBib#(OfficialsOnly)
Address_________________________________________________________________________
StreetCityStateZip
E-MailAddress_________________________________________________(pleaseprintlegibly)
(veryimportanttoincludeemailsowecansendyounextyear’sregistra,onform)
T-shirtguaranteedforpaidregistra,onsreceivednolaterthan10/18/13
ShirtSize(circleone):SMLXLXXL
WAIVER/HOLDHARMLESSAGREEMENT
___________________________ herebyagreestoprotect,defend,indemnifyandsaveharmlessandreimburseTownshipHighSchoolDistrict214,itsBoard,officers,
agentsandemployees(hereinaCerreferredtocollecvelyas“TownshipHighSchoolDistrict214”)fromandagainstanyandallloss,claims,lawsuits,liability,expenses
andaIorneys’feesandcostsofanykindandnaturewhatsoever,whichTownshipHighSchoolDistrict214mayincurarisingoutoforinconneconwithanyclaimeddamage
to,lossordestruconofpropertyorbecauseofclaims,demands,lawsuits,acons,seIlements,orjudgmentswhatsoeverforbodilyinjury,sicknessordisease,includingdeath,
sustainedbyanypersonresulngfromorinconneconwithorbyreasonoftheuseofsaidTownshipHighSchoolDistrict214bymeormyguestsorinvitees,includinganysuch
claimorproceedingbasedinwholeorinpartonanyallegednegligence,strictliability,contribuon,indemnityorotherallegaonagainstsaidTownshipHighSchoolDistrict
214exceptthesoleandexclusiveconductofTownshipHighSchoolDistrict214.Thepartyintendsthisindemnificaontobegivenitsbroadestapplicaontoallclaims.
Datedthis______dayof________________2013.By:______________________________________________________
Signature(Parent/Guardianifunder18) Printandsendcompletedformwithcheck/moneyorderto: Mr.JimVoyles
RollingMeadowsHighSchool 2901W. CentralRoad
RollingMeadowsIL60008
Pleasemakechecksoutto‘ShannonMcNamaraMemorialScholarshipFund’
OrsignuponlinehIps://www.signmeup.com/site/online-event-registraon/95309/SMUalendar