Entry Form & Waiver

NAME: _________________________________________________________________

ADDRESS: ______________________________________________________________

City/State/Zip: ___________________________________________________________

Age__________ (as of 10/14/10)       Male:_______       Female:_______             Phone:_____________

$15.00 entry fee before October 10, 2010
$20.00 entry fee after October 10, 2010
Entry includes t-shirt and Cheese Festival Pass
$10.00 entry fee without t-shirt
Register early t-shirt limited to first 100 runners.

RACE (Check one)             __________10 km      __________5 km             __________1 Mile Fun Run
Shirt Size (Check one)             _____S             _____M             _____L             _____XL

Waiver (must be signed)

Notice: This entry form and release form is a contract with legal consequences. Read it carefully before signing.
I know that running a road race is a potentially hazardous activity. I should not enter and run unless I am medically able and properly trained. I also know that although police protection will be provided, there will be a possibility of traffic on the course route. I assume the risk of running in traffic. I also assume any and all other risks associated with running this event including, but not limited to, falls, contact with other participants, the effects of the weather, and the conditions of the roads, all such risks being known and appreciated by me. Furthermore I agree to yield to all emergency vehicles. I also am fully aware that baby strollers, baby joggers, pushed wheelchairs and wheels of any kind (except competitive wheelchairs in a separate race), animals and head phones are strictly prohibited and I agree not to have them on the course. Furthermore, I agree not to go back on the course after finishing. I am fully aware that allowing someone else to wear my race number, switching race numbers or running under a false name is a fraudulant act and I agree not to do this. Knowing these facts, and in consideration of your accepting my entry, I hereby for myself, my heirs, executors, administrators or anyone else who might claim on my behalf, covenant not to sue and unconditionally waive and release and discharge the USATF/Oklahoma/LDR, Watonga Cheese Festival Committee, Watonga Chamber of Commerce, Watonga Police Department, Watonga Fire Department, Watonga Civil Defense, National Guard Detachment Company B 180 Infantry race officials, volunteers and all sponsors including any and all of their agents, employees, assigns or anyone acting for or on their behalf from any and all claims or liability for death, personal injury or property damage of any kind or nature whatsoever arising out of, or in the course of my participating in this event whether same be caused by negligence or fault. This release and waiver extends to all claims of every kind or nature whatsoever, forseen or unforseen, known or unknown. The undersigned further grants full permission to sponsors and or agents, authorized by them to use any photographs, video tapes, motion pictures, recordings, or any other record of this event for any purpose. Applications for minors will be accepted only with a parent or guardian's signature.

Runner's Signature

Parent/Guardian (if minor)

Date                                       Running Club

Please Send Entry Form & Make Payment To:
Watonga Rat Race
Rt 2, Box 337-A
Watonga, OK 73772

Cheese Festival Page
             Chamber of Commerce Page
                          watonga.com