Strides for Safety
5K Green Run/Walk Sunday, September 13, 2009 Aventura Mall 7:00 AM
T-Shirt: Small Medium Large X-large
With my signature, I acknowledge that running and walking can be inherently stenuous activity and that no event is without risk. I have consulted with my physician regarding my physical capability to participate in this event and am following my physician's advice. I hereby waive all claims against Split Second Timing, The City of Aventura , Aventura Mall, The University of Miami, Ryder Trauma Center, all event sponsors and volunteers , and any personnel functioning with respect to the event for any injury, accidents, or physical conditions I might suffer in this event. I grant full permission for organizers to use my name, likeness, or voice and photographs, videotapes, or quotations from me in accounts and promotions in any medium of this event, and of the activities of Split Second Timing. This permission is perpetual and worldwide.
Signature (Parent/Guardian's Signature if under 18 years) ________________________________________
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1 Mile Safety Walk Participants. ( T Shirts Given ).........$ 10
Make check payable to: University of Miami William Lehman Injury Research Center
Mail checks/entry form to: Split Second Timing 2211 Charleston Weston, Florida 33326