Running of the Elk & Shamrockn' 1/2 Marathon Training Registration- 2012

Name _______________________________________________________________________

Address _____________________________________________________________________

City, State, Zip _______________________________________________________________

Phone: Home ___________________________ Cell ________________________________

Any Health Related Issues we should know about? ex. asthma, diabetes, etc. _________________________

Emergency Contact Person:__________________Their Phone #:__________________

Your E-mail:_______________________________________________________________________

Shirt Size/ gender _______________________Birthday _______________________________

Registration fee:  $99 first-timers/ $89 Running Zone training group alumni

Check _____NA_______          Cash ___________

(Please make check to The Running Zone)

By signing this document, I acknowledge that I have been informed of the need to obtain a physician’s

examination and approval prior to beginning this exercise program.  I fully understand that the program

or procedures may be strenuous and choose to participate completely voluntarily.  I accept all

responsibility for my health and any resultant injury or mishap that may affect my well-being or health

in any way.  I hold harmless of any responsibility the instructor, trainer, or facility, or any persons involved

with this program or testing procedures.

Print Name _________________________________________________________________________

Signature __________________________________________Date ___________________________

……………………………………………………………………………………………………………….

Please send registration form to:

The Running Zone

ATTN: Mimi
8470 Elk Grove Blvd., #135

Elk Grove, CA 95758

Or bring it on your first day of training.  Thank you.