Registration Form International Country Club 11th Annual Charity 5k Run/Walk On March 23, 2019
All participants must complete this registration form, sign the liability waiver, and pay a $35 registration fee.
To Receive a T-shirt, you must be registered by March 13th
Please download and e-mail this registration form along with your signed liability waiver to [email protected] or bring both completed forms to the fitness center,
On Saturday, March 23rd, Shirt pick-up and check-in at the clubhouse lobby begins at 6:30 a.m. Race starts at 7:00 a.m. Rain or Shine
1. Members may register guests for the event. Guest that want t-shirt must submit registration form, waiver and fee by the t-shirt deadline (March 13). Otherwise, they may register up to or on the day of the event. 2. Children under the age of 13 yrs. old must be accompanied by adult at all times. 3. No stepping on the grass (we will be doing a staggered start so there are a limited number of runners starting the race at the same time.) 4. The golf cart path contains some areas of rough terrain and bumps. Run at your own risk and BE CAREFUL.
International C.C. Fitness Center 5k Waiver and Release
desire to participate in the International Country Club charity run and agree to abide by the rules and regulations of the ICC Fitness Center.
I am fully aware that physical fitness exercise, testing and/or training is a potentially hazardous activity which could result in injury, illness, medical complications, or even death to me and/or other persons within the Fitness Center or ICC in general. I hereby (a) certify that I am physically able to participate and engage in physical fitness exercise, testing and/or training; and (c) agree to promptly notify the Fitness Center management of any adverse change in my health that bears on my physical ability to participate and engage in physical activity or run.
In exchange my participation in the ICC run , I, on my own behalf and on behalf of my heirs, assigns and personal representatives, hereby accept any and all responsibility, ASSUME ALL RISK AND FOREVER WAIVE AND RELEASE International Country Club and the Fitness Center management ( and their respective officers, employees, agents, and representatives) for, from and against any and all losses, costs, damages, demands, claims, and liabilities, whether direct or indirect, and whether based on any injury, illness, death, damage of any kind or nature, or otherwise, that may occur in the Fitness Center or result directly or indirectly from my participation in the 5k/charity run/walk.
