Red Rock Scramble Registration Form
Limited to first 250.
Check web site or email dselden@narf.org
5K & 5Mile Run/Walk, October 3, 2010, 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

NAME: _______________________________

ADDRESS: _________________________________ City:__________________ State:_________

PHONE: _________________________ E-MAIL: ______________________________________

Male ____ Female ____                     Check one - I want a cool eco-friendly beanie hat: ____ (one size fits all) or I don't want a hat:____ (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)