Save the Date!
Soroptimist International of Cody, WY will host...
Our 4th Annual 'Run for Hope' is set for Saturday, October 6th!
Join us for 5k/10k Walk/Run, Chip Timed, a Kid's Race, Bounce House, Music & Vendors!
$25.00 in Advance / $30.00 Race Date / $10.00 Kids Race
Register online TODAY at:
https://www.onestoprace.com/Register/?event=12338
or at wasptiming.com.
You may also open, print out & mail in the form attached to this page
or pick up a registration form from any Soroptimist member.
5k / 10k Race Route Map
REGISTRATION FORM:
October 6, 2012
Proceeds benefit-
Lainey Cole Memorial Women’s Cancer Fund
Cody Quad Center, 1402 Heart Mountain St., Cody, WY
Start: 10:00 a.m. Check-In: 9:00 a.m.
$25 Advance $30 Day of Race
Kids’ Race $10 Start: 9:00 a.m. Check-In 8:30 a.m.
Name: _____________________________________________________________________________
Address:_____________________________________________________________________________
City:_______________________State:_________Phone#:_____________________________________
Email:______________________________________________________Age: _______Gender:________
Race: 5k_____10k______ Kids Race_______Additional Donation:_______________________________
General Waiver: I hereby for myself, my heirs, executors and administrators, waive and release any and all rights and claims for damages I may have against colradoregisters.com, its affiliates, and subsidiaries, and their respective directors, and employees, and sponsors, coordinating groups and any individuals associated with Run for Hope Benefiting the Lainey Cole Memorial Women’s Cancer Fund on 10/06/2012, their representatives, successors and assigns, and will hold them harmless for any and all injuries suffered in connection with this event. I attest that I am physically fit to compete in this event. Athlete is fully aware of the risks and hazards inherent in participating in the Event and hereby elects to voluntarily participate, knowing the risks associated with the Event. Athlete hereby assumes all risks of loss(es), damage(es), or injury(ies) that may be sustained by him/her while participating in the Event. Further, I hereby grant full permission to any and all of the foregoing to use my likeness in all media including, but not limited to photographs, newspapers, brochures, or any other records of this event for any legitimate purpose without compensation. Athlete acknowledges that the entry fee paid is non-refundable and non-transferable. Athlete acknowledges and agrees that Run for Hope benefiting the Lainey Cole Memorial Women’s Cancer Fund, in its sole discretion, may delay or cancel the Event if it believes the conditions on the race day are unsafe. In the event the Event is delayed or cancelled for any reason, including but not limited to: fire, threatened or actual strike, labor difficulty, work stoppage, insurrection, war, public disaster, flood, unavoidable casualty, acts of God or the elements (including without limitation, rain, hail, hurricane, tornado, earthquake), or any other cause beyond the control of Run for Hope Benefiting the Lainey Cole Memorial Women’s Cancer Fund there shall be no refund of the entry fee or any other costs of Athlete in connection with the Event. ATHLETE HAS READ THE FOREGOING AND INTENTIONALLY AND VOLUNTARILY SIGNS THE RELEASE AND WIAVER OF LIABILITY AGREEMENT. IF ATHLETE IS UNDER AGE 18 HIS/HER PARENT OR GUARDIAN MUST SIGN THIS RELEASE AND WIAVER AGREEMENT. Athlete’s Parent or Guardian’s signature has read and understands the foregoing RELEASE AND WAIVER OF LIABILITY AGREEMENT (above) and by signing intentionally and voluntarily agrees to its terms and conditions. Athlete’s Parent/Guardian further certifies that my son/daughter/ward is in good physical condition and is able to safely participate in the Event. I hereby authorize medical treatment for him/her and grant access to my child’s medical records as necessary and as state above.
Participant/Guardian_________________________________________________Date______________
Soroptimist International of Cody
P. O. Box 1914
Cody, Wyoming 82414
Cash______CK_______
October 6, 2012
Proceeds benefit-
Lainey Cole Memorial Women’s Cancer Fund
Cody Quad Center, 1402 Heart Mountain St., Cody, WY
Start: 10:00 a.m. Check-In: 9:00 a.m.
$25 Advance $30 Day of Race
Kids’ Race $10 Start: 9:00 a.m. Check-In 8:30 a.m.
Name: _____________________________________________________________________________
Address:_____________________________________________________________________________
City:_______________________State:_________Phone#:_____________________________________
Email:______________________________________________________Age: _______Gender:________
Race: 5k_____10k______ Kids Race_______Additional Donation:_______________________________
General Waiver: I hereby for myself, my heirs, executors and administrators, waive and release any and all rights and claims for damages I may have against colradoregisters.com, its affiliates, and subsidiaries, and their respective directors, and employees, and sponsors, coordinating groups and any individuals associated with Run for Hope Benefiting the Lainey Cole Memorial Women’s Cancer Fund on 10/06/2012, their representatives, successors and assigns, and will hold them harmless for any and all injuries suffered in connection with this event. I attest that I am physically fit to compete in this event. Athlete is fully aware of the risks and hazards inherent in participating in the Event and hereby elects to voluntarily participate, knowing the risks associated with the Event. Athlete hereby assumes all risks of loss(es), damage(es), or injury(ies) that may be sustained by him/her while participating in the Event. Further, I hereby grant full permission to any and all of the foregoing to use my likeness in all media including, but not limited to photographs, newspapers, brochures, or any other records of this event for any legitimate purpose without compensation. Athlete acknowledges that the entry fee paid is non-refundable and non-transferable. Athlete acknowledges and agrees that Run for Hope benefiting the Lainey Cole Memorial Women’s Cancer Fund, in its sole discretion, may delay or cancel the Event if it believes the conditions on the race day are unsafe. In the event the Event is delayed or cancelled for any reason, including but not limited to: fire, threatened or actual strike, labor difficulty, work stoppage, insurrection, war, public disaster, flood, unavoidable casualty, acts of God or the elements (including without limitation, rain, hail, hurricane, tornado, earthquake), or any other cause beyond the control of Run for Hope Benefiting the Lainey Cole Memorial Women’s Cancer Fund there shall be no refund of the entry fee or any other costs of Athlete in connection with the Event. ATHLETE HAS READ THE FOREGOING AND INTENTIONALLY AND VOLUNTARILY SIGNS THE RELEASE AND WIAVER OF LIABILITY AGREEMENT. IF ATHLETE IS UNDER AGE 18 HIS/HER PARENT OR GUARDIAN MUST SIGN THIS RELEASE AND WIAVER AGREEMENT. Athlete’s Parent or Guardian’s signature has read and understands the foregoing RELEASE AND WAIVER OF LIABILITY AGREEMENT (above) and by signing intentionally and voluntarily agrees to its terms and conditions. Athlete’s Parent/Guardian further certifies that my son/daughter/ward is in good physical condition and is able to safely participate in the Event. I hereby authorize medical treatment for him/her and grant access to my child’s medical records as necessary and as state above.
Participant/Guardian_________________________________________________Date______________
Soroptimist International of Cody
P. O. Box 1914
Cody, Wyoming 82414
Cash______CK_______