8/14/2019 Team Relay Registration Form - Blue Ridge Marathon

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Five-Person Team Relay

Registration Form

April 24, 2010Roanoke, VA

www.BlueRidgeMarathon.com

Please fill out completely. Incomplete forms will not be accepted Each individual team member must complete a registration form Mail all team member forms together. Forms sent individually will not be accepted Mail only one check (made payable to Blue Ridge Marathon) for total team amount. Team amount applies

regardless of number of team members

Team Name: ___________________________ How many team members? ______

Captain Name: __________________________

Team Category (Captain - check all that apply): ___ Corporation ___ Non-profit group ___ Military Group___ College ___ All Male ___ All Female ___ CoedOther: ________________

First Name______________________ Middle Initial ________ Last Name ______________________________

Street Address ________________________________________________________________________________

City, State, Zip Code ___________________________________________________________________________

Phone (_____) ______ - _________ Gender ______ Birth date __________________

Age (Day of Race) ________ Email Address _______________________________________________

Shirt Size: XS ___ S ___ M ___ L ___ XL ___ XXL ____ (must register by April 4 for t-shirt)

Relay Fees: Before 12/31/2009 - $150Before 3/15/2010 - $165Through 4/22/2010 - $180

Make Checks Payable to: Blue Ridge MarathonMail to: Blue Ridge Marathon

111 Franklin Plaza, Suite 333Roanoke, VA 24011

In consideration of your accepting this entry, I the undersigned, intending to be legally bound, hereby for myself, my heirs,executors and administrators, waive and release any, and all rights and claims for damages I may have against Blue Ridge

Marathon on the parkway, Odyssey Adventure Racing, other organizations associated with this event and their representatives,successors and assigns, the City of Roanoke, the County of Roanoke, the National Park Services and any or all sponsors for anyand all injuries suffered by me in said event. I attest and verify that I will participate in this event as a footrace entrant that I amphysically fit and have sufficiently trained for the completion of this event and my physical condition has been recently verifiedby a physician. I understand that this is not a normal marathon, that it includes multiple uphill and downhill portions with acombined elevation change of over 6000.

_________________________________________ ________________________________________All entrants must sign waiver. Legal Guardian must sign if entrant is under 18 years old.

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