Generic XC Application (Good for all races)
|The Name of the Race you are entering ____________________________________ Date _________|
|Pre-Reg Fee Enclosed ___________ Check # ________||official use only|
|Race Day Fee __________ D.O.B. ____/____/____ Age: ______|
|Entrants Name ________________________________________________________ Sex: __ M __ F|
|PLEASE print your name clearly and use the same last name as used on your PAUSATF membership.|
|Address __________________________________________________ Email: ____________________|
|City _______________________________________ State ____ Zip ________|
|Phone (Day) ___________________ (Eve) ___________________|
PACIFIC ASSOCIATION RUNNERS (Write in association if other than
PA/USATF Club Name ________________________________________ Club Number ______
WAIVER: (The following must be signed to enter the race. If you are under 18, your parent or guardian must sign for you.) In consideration of your accepting my entry, I, intending to be legally bound, do hereby for myself, my heirs, executors and administrators waive and release forever any and all rights and claims or damages I may accrue against any and all organizations, sponsors, and/or individuals connected with this event, their representatives, successors and assigns for any and all injuries suffered by me in connection with this event including pre and post race activities.
Signature ___________________________________ Date:______________
For race registration mailing addresses, see detailed Cross Country Schedule for each individual event.