Gator Chase    5/15/16

Please mail completed application to:
Greentree Elementary
Attn. Shannon Brabham
3502 Brookshadow Drive
Kingwood, TX 77345  

Name _____________________________________                    Male / Female

Address ___________________________________       Age on race day ________            

City, State, Zip _______________________________                  

Phone (day) ________________ night ________________          

Email address ___________________________________   

Gator 5K _____                                                                                                            $     25.00

Gator 5K & 1 Mile (age 12 and under) Combo Package    _____                  $      30.00

Gator 1 Mile (age 12 and under)  _____                                                                   $     15.00

Lazy Gator (spectator with shirt)  _____                                                                  $    15.00

Race Day Gator 5K     _____                                                                $      30.00

Shirt size: Youth    Small       Medium     Large        Adult   Small    Medium   Large    XL    XXL 
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Donation to Greentree Elementary to promote health and fitness                            $ ________
Make check payable to:   
Greentree Elementary                Total Enclosed    $ ________

Waiver Must Be Signed

Waiver: All participants in the Gator Chase events assume all risk of participation in the event by signing the release agreement.  I the undersigned athlete on behalf of myself and on behalf of my heirs, my executors, my administrators and my trustees, waive and release any and all rights and claims for any loss(es), injuries and damages including, but not limited to demands or actions for negligence, premises liability, emotional injury, intentional conduct, tort claims, and any other actions or demands of whatever nature, I have or may have against 1) Gator Chase, 2) its officials, agents and representatives, 3) Greentree Elementary and Humble, ISD, 4) all sponsors of the event in which I may participate whether my participation is as a contestant or as a spectator.  I acknowledge that I am aware of the inherent risks involved in this event and I voluntarily assume the risks.  I attest and verify that I am physically fit and I have sufficiently trained for the competition of the above-mentioned event in which I participate.  I hereby grant full permission to any and all of the foregoing to use my name, and/or my picture in any account of this event for any purpose whatsoever.  I have read the entry information provided for the event and certify my compliance by signing below.  Athlete acknowledges that the entry fee is non-refundable and non-transferable.

Signature of athlete_______________________________ Date ___________

* Signature of parent/guardian ______________________ Date ___________

*(if athlete is under 18) I certify that my son/daughter has my permission to compete in the Gator Chase events, is in good physical condition and that race officials have my permission to authorize emergency care if necessary.