Apocalypse Survivors Marathon/Half Marathon   2012

Please mail completed application to:

Yen Nguyen
703 McGowen St. #5211
Houston, TX 77006

Email: run4foodandfun@yahoo.com

Name _____________________________________                    Male / Female (circle)

Address ___________________________________                     Date of birth   ________            

City, State, Zip _______________________________                   Age on race day    _____            

Phone (day) ________________ night ________________             Shirt size (S, M, L, XL, XXL)   ____         

Email address ___________________________________          **** NON ZOMBIES ONLY ****

Event  (circle one)       Marathon          Half marathon                  

Entry fee         $50 thru 11/30       $55 12/1 thru 12/22           $65 race day                       

Make check payable to:   Yen Nguyen                             Total Enclosed    $ _________

Emergency Contact Name and Phone#   __________________________________________

Allergies/Conditions:   ________________________________________________________


Waiver Must Be Signed
AMATEUR ATHLETIC WAIVER AND RELEASE OF LIABILITY

In consideration of being allowed to participate in any way in the Apocalypse Survivors Marathon/Half Marathon related events and activities, the undersigned acknowledges, appreciates and agrees that:  

1. The risk of injury from the activities involved in the program is significant, including the potential for permanent paralysis and death, and while particular rules, training and personal discipline may reduce this risk, the risk of serious injury does exist; and

2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARRISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and  

3. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest race official immediately; and  

4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS, the Apocalypse Survivors Marathon/Half Marathon, their respective officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, (owners and lessors of premises used to conduct the event) (all hereinafter referred to as “Releases”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.  

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, I FULLY UNDERSTAND ITS TERMS, I UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARYILY WITHOUT ANY INDUCEMENT 

Participant signature__________________________________________________________Date____________________ 

Participant Printed Name_________________________________________________________