YOU MAY REGISTER THE DAY OF THE EVENT OR COMPLETE THE PRE-REGISTRATION FORM

Mail to ATTN: Brenda Jacobson Rebel Softball

5201 Holiday Lane

North Richland Hills, Texas  76180 

NAME: ___________________________________  T-SHIRT (circle one)   Adult Small   Adult Medium   Adult Large    Adult X-Large    

ADDRESS: ____________________________________________  CITY: ____________________________________

CHECK APPROPRIATE:  _____ 5K RUN/WALK   _____ 1 MILE FUN RUN    _____ BOTH  

INDICATE NUMBER OF RUNNERS:   ____ 18 AND UP  ($20)   ____  Under 18 ($15)   ____ Under 5 (Free)   $______Total Enclosed

Make checks payable to: RHS Softball Booster Club    

Release:  I realize the event is physically strenuous, and there may be adverse weather conditions, as well as vehicles on the course.  Nevertheless, I wish to compete and assume all risk of injury.  I hereby, for myself, and anyone entitled to act on my behalf, release and discharge Richland High School and the Softball Booster Club from any and all claims of injury or liabilities of any kind, illness or damage suffered by me, as a result of my participation in or traveling to this event.  I realize the entry fee is non-refundable.  I have read and understand my responsibility. I am making this agreement and paying my entry fee in exchange for the privilege of running this race and using the facilities provided by the race.

Signature (parent or guardian if under 18) ________________________________________  Date:__________________

(Additional family members sign for release on the back of this form and include shirt size and age.)