No added fees for online registration -- pay $10 when you show up on race day
Pre-registered: $10
Day of Race: $20
Male/ Female
Name: ________________________________
Age: ________
Sock size: (circle) small medium large extra large
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
1733 North Street SE
Olympia, WA 98501
