Red Rock Scramble Registration Form
5K & 5Mile Run/Walk, October 4, 2009, 10am. Lyons, CO.
See: www.coloradoindianbar.org
Presented by the Colorado Indian Bar Association.
To benefit the CIBA Scholarship Fund for Native American Law Students at Colorado
Law Schools
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Entry Fees Mail by Sep. 28: $23.00 - with shirt |
Please Return Registration to: |
NAME: _______________________________
ADDRESS: _________________________________ City:__________________ State:_________
PHONE: _________________________ E-MAIL: ______________________________________
Male ____ Female ____
Check one - I want a cool eco-friendly exercise shirt: ____ (circle size: XXL XL L M S) or I don't want a shirt:____ (save $10)
5 K ____ or 5 Mile ____
Age on Race Day: ________
Legal Release: In consideration of this entry in the CIBA Red Rock Scramble,
I hereby release the Colorado Indian Bar Association, the associated sponsors,
and their respective officers, members, agents, and employees from any actions,
claims, and demands of any kind and nature (before, during, or after the event)
that may arise from, or in connection with, any participation or proposed participation
in this event. I accept the risks involved and waive all rights of any kind
that may otherwise exist. I attest that I am physically conditioned and have
trained for the event. I am responsible for my own safety. I also consent to
the free use of my name and picture in any broadcast, telecast, or print media
concerning this event. In signing this form, I acknowledge that I have read
and fully understand my own liability and accept the restrictions.
Signature:______________________________ Date_____________________
*(Registrations for participants under 18 must be signed by parent or adult
guardian)