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Course Support - Huntingtons Disease
   Sunday, January 15, 2017 (05:30 AM - 12:30 PM)

* Required fields

* First Name:
* Last Name:
* Address:
* City:
* State:
or * Province:
* Zip/Postal Code:
* Country:
* Gender Female Male
* Date of Birth:  
* Email :
* Home Phone:
Work Phone:
*T-shirt Size:
(eg: who you'd like to work with,
or, list second volunteer choice):
In consideration of the foregoing, I for myself, my heirs, executors and administrators, waive and release any and all rights and claims for damages I have against In Motion, Inc., Tri-City Medical Center Carlsbad Marathon, it's principals, the City of Carlsbad, USA Track & Field Assoc., Westfield Plaza Camino Real/Westfield ShoppingTown, all sponsors and their representatives and any and all claims and damages, demand, actions whatsoever in any manner as a result of my participation in said marathon, including, but not limited to, any risks in participating in an athletic event of this type. I attest and verify that I am physically fit and have sufficiently trained for this event and have been verified by a licensed medical doctor. Further, I hereby grant full permission to any and all of the foregoing to use my name, my voice, and my picture in any broadcast, telecast, advertising, promotion or other account of this event for any purpose whatsoever. I understand that to volunteer I must be 13 years or older.
Registration for minors must be completed by a Parent or Legal Guardian. If your age on race day is less than 18 years old, please fill in the Parent/Guardian Contact Information below. Providing such information and continuing this process indicates that this registration was completed by the person listed below.
Parent/Guardian Name:
Contact Phone:
Contact Relationship:
*Agree to waiver: I agree I do not agree