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              Last Name                    First                 M.I.

         Sex: M____  F____ Date of Birth:__________________ Age____________

                                                         (as of 4/29/18)
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              Address

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              City                         State                    Zip
           
         Email:_______________________ Day Phone:__________________________


         Proposed Distance: 5K___ 15K___  T-Shirt Size: S___M___ L___ XL___
   
        

Packet Pickup Location: Lora's___ Race Day___

Waiver of Claim (Must Be Signed): In consideration of acceptance of this entry, I, the 
undersigned, assume full and complete responsibility for any injury, illness, or accident which may occur 
during my participation in the Germanfest Fun Run or while I am on the premises of this 
event; and I hereby release and hold harmless the sponsors, promoters and all other persons and entities 
associated with this event from any injury or damage, whether it be caused by negligence of the sponsors 
or promoters or persons or entities associated with this event.  Further, I grant full permission to use my 
photographs, videotapes, or recordings of this event for any legitimate purpose.  All runners under 14 years 
of age must be accompanied by parent or guardian.

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           Signature of runner

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           Signature of parent if under 18