December 23rd , 2017 White Elephant Run

Pre-registered (Received by December 21st, 2017) : $5

Day of Race: $10

Male/ Female

Name: ________________________________

Age: ________

Phone: _______________________________

Address: ______________________________


email: _________________________________

Waiver Release: I hereby certify the following: (1) I am medically able and properly trained to participate in the White Elephant Run; (2) I further agree in the event of an injury or accident that event officials may authorize necessary treatment for me and I further authorize the American Medical Response (AMR), Olympia and Tumwater Fire Dept. (OFD) or any other medical treatment provider to furnish to the event organizers my name, telephone number, and if applicable, the name of any hospital or medical facility I was transported to as a result of any injury or medical problem that arose out of this event; (3) I further grant the White Elephant Run specific permission to reproduce, publish, circulate, copyright, or otherwise use an and all photographs and/or videotape of me and/or my family, taken at the event; and (4) I voluntarily agree to assume the full risk of any and all injuries that I (or my child) may sustain as a result of my participation in the White Elephant Run.  I assume all risks and hazards incidental to participation in the Whilte Elephant Run.  Having read this waiver and knowing these facts, and in consideration of the acceptance of my entry into this event, 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 hold harmless all subsidiaries, affiliates, assigns,
representatives and successors of the foregoing: The City of Olympia, its officers, officials and employees  ,  , The City of Tumwater, its officers, officials and employees  ,  and all event sponsors, suppliers, agents, independent contractors, employees and any other personnel in any way assisting or connected with the White Elephant Run from any and all claims of liability of any kind whatsoever.  Entries cannot be accepted without a valid signature. Entries from minors will only be accepted with a parent or legal guardian’s signature.

Signature _______________________________ Date _______

Mail to:

White Elephant Run

5129 Chambers Creek Loop SE

Olympia, WA 98501

Or bring registration to the Olympia South Sound Running Store

November 19th  – 3:00 PM December 16th @ 3:00 PM


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