Urban Cow/ Nike Women's 1/2 Marathon Training Registration- 2010

Name _______________________________________________________________________

Address _____________________________________________________________________

City, State, Zip _______________________________________________________________

Phone: Home ___________________________ Cell ________________________________

Emergency Contact Person:__________________Their Phone #:__________________

Your E-mail:l _______________________________________________________________________

Birthday _______________________________

Registration fee:  None

Check _____NA_______          Credit Card #/exp. __________NA________________________

(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.