-----------------------------------------------------------------------------------------------------------

Please Print Cleary             Sign Waiver!!              Form May be Duplicated

Last Name_____________________ First Name _________________________

Street Address_______________________________________­­­­­______________

City _________________________ State__________ Zip_________ Sex: M     F

Email ____________________@________________

Race Day Age ___________ Date of Birth___/___/___ Tel: (______)________________________  

Shirt Size (circle one): S   M   L   XL             Race: QM HM FM    2P 4P Relay

Fees: Marathon $65   HM $45   QM $30   Fees increase $10 after 4/1/2010, increase another $10 on 5/1/2010

Fee: ________________ Relay Only: Team Name _______________________

Team Mates: _____________________________________________________

WAIVER: I know that running a trail run is a potentially hazardous activity.  I should not enter or run unless I am medically able & properly trained.  I also know that there will be traffic, debris, and poor footing on the course and assume the risk for running on it.  I also assume any or all other risks associated with running or attending the race including but not limited to falls, contact with other participants, the affects of the weather, the conditions of the roads and getting lost, all such risks being known and appreciated by me.  Knowing these facts, and in consideration of your accepting my entry fee, I hereby for myself, my heirs, executors, administrators or anyone else who might claim on my behalf, covenant not to sue, and waive, release and discharge ARQ RC, Morris County Parks Commission, Newark Watershed Authority and all municipalities in which the event is held, the race committee, volunteers, all other organizations directly or indirectly associated with the race, any or all sponsors including their agents, employees, assigns or anyone acting on their behalf, or anyone else associated in any way with this race, from any or all claims or liability for death, personal injury or property damage of any kind or nature whatsoever arising out of , or in the course of, my participation in  this event.  This waiver extends to all claims of every kind or nature whatsoever; foreseen or unforeseen, known or unknown. By entering this race, I am granting permission to ARQ RC to use any pictures or likenesses of me secured at the event in any way they see fit without review, restriction or compensation.  

I HAVE READ & UNDERSTAND THIS WAIVER:

SIGNATURE (of parent if under 18)