Release of Liability
In consideration for allowing me to compete in the BLAZE RACE, I, the undersigned, intending to be legally bound, waive and release, for myself, my heirs, executors and administrators, any and all rights and claims for property damage and personal injury, including death, which I may have against the United States Air Force, the United States Government, the volunteer medical support, all participating supporting volunteers and their representatives, successors and assignees, arising from my participation in this event.
I have read the foregoing information and understand it. Any questions that may have occurred to me have been answered to my satisfaction. I understand that I am free to withdraw from this program without prejudice at any time I desire.
Signature of Participant
____________________________________________ Date________________________________________
Signature Of Parent/ Guardian (if under 18)
____________________________________________
Date________________________________________
HELMETS MANDATORY FOR BIKERS
NO EXCEPTIONS
REGISTRATION
One person to a form. Form may be duplicated. If duplicated be sure to duplicate and sign release form on back. PLEASE PRINT.
Name:
Address:
City, State, Zip:
Phone:
Emergency Contact:
Contact Phone:
Age (on run date):
Driver Liscense #
(ID is required to enter a government installation)
Entry Fees
1/2 Marathon and Biathlon $20.00
10 K $15.00
5K Race $10.00
Total Enclosed __________________
Shirt Size:
Men’s: ___ S ___ M ___ L ___ XL
Women’s: ___ S ___ M ___ L ___ XL
Cash, Check, or Money Order Only!
Checks Payable To: 14 Services Division
Forms must be post marked by September 1, 2006 to be guaranteed a shirt on race day.
RACE TIDBITS
1/2 Marathon: Course is eight miles on the perimeter road and five miles will be run on the flight line.
Biathlon will consist of a 13.1 mile ride on unimproved gravel road and the flight line, then a 10K trail run.
10 K will be a trail run.
5 K will be run on paved road.
All courses will be traffic-controlled and have water stations.
Parking is available directly behind the Columbus AFB Fitness Center, off "D Street."
* RACE RAIN OR SHINE*
Awards will be given for top three finishers in each event. The top male and female in each age group will also be awarded in the 10K, 1/2 Marathon and Biathlon.
Age Groups:
16-19 35-39
20-24 40-44
25-29 45-49
30-34 50+
DIRECTIONS TO THE EVENT:
From Tuscaloosa: Take Hwy 82 W to Hwy 45 N. Follow Hwy 45N for 7.5 miles. Turn left on to Hwy 786. Follow for 3/4 mile, this will take you to the front gate.
From Tupelo: Take Hwy 45 S to Hwy 786. Turn right. Follow for 3/4 mile, this will take you to the front gate.
From Starkville: Take Hwy 82 E to Hwy 45 N (Aberdeen exit). Follow Hwy 45 N for 7.5 miles. Turn left on Hwy 786. Follow for 3/4 mile, you will be at the front gate to the base.
*Please have ID available at front gate.
RACE INFORMATION
Date: Saturday, September 16, 06
Start Location: Columbus AFB Fitness Ctr.
Check In: 6:30-7:30 a.m.
Race Meeting: 7:45 a.m.
Race Starts: 8:00 a.m.
Event Fee:
Biathlon and 1/2 Marathon $20.00
10 K $15.00
5 K $10.00
(price includes moisture wicking shirt)
* Minimum age 16