Frozen Foot 5K Run/Walk

Sunday, February 21^st 2010

Registration Form

last name:________________First Name: ___________

Sex: ____Date of birth:______Race Day= Age: ______ PHone: ________________ e-mail: ____________________

Address:_________________ City:______= _ State:______

PAYMENT Method: cash_______ check_______

check number :___________(Made out t= o CU Tri Team)

: RUN WALK =

        =             &nb= sp;            =          T-ShirtSize (circle one)

      S

       $17 Customary Entry (T-shirt) = STUDENT   February 2 – February 20       $20 = Race Day (No T-Shirt) STUDENTS<= /span>   vali= d thru: F= ebruary

$15 Bare-Bones (No T-Shirt) valid thru: F= ebruary 2 – February 20 = XL TEAM NAME: _______________________

&= nbsp; **Teams must mail all registratio= ns in one envelope to receive the $3 discount

Time: Race goes off at 9 a.m. RAIN= or SHINE!

Location:&= nbsp; CU Main Campus, Duane Physic= s. Located at 2000 Colorado Ave.

Help send the CU Triath= lon Team to 2010 Collegiate Nationals!!

75% of race proceeds go= to CU Tri Team

Please read and sign Wai= ver:I e= xercise my own free choice to participate in the above designated Activity. I understand and assume all associated risks. I agree to assume all risk of personal injury or lo= ss, bodily injury (including death), damage to or loss or destructions of any personal property occurring in connection with or arising out of participat= ion in the Frozen Foot 5K. I hereby release and dischar= ge, indemnify and hold harmless University of Colorado, Racing Underground, and their member officers, agents, employees and any other persons or entities acting on their behalf, and the successors and assigns for any and all of t= he aforementioned persons and entities, against all claims, demands, costs and expenses, and causes of action whatsoever, either in law or equity, arising= out of or in any way connected with any loss and/or bodily injury and/or disability, arising from my participation in the Activity. I have read this document and understand it’s contents. PARENT/GUARDIAN = WAIVER FOR MINORS (Under 18 years old) The undersigned parent and natural guardian does hereby represent that he/she is, in fact, acting in such capacity and agrees to save and hold harmless and indemnify each and all of the parties referred to above form all liability, loss, cost, claim or damage whatsoever which may be imposed upon said parties because of an defect in or lack of s= uch capacity to so act and release said parties on behalf of the minor and the parents or legal guardian. In= the event of an emergency, I grant the University of Colorado permission to authorize emergency medical treatment for _____________________ (parti= cipant) for the duration of my/his/her participation in this Activity. I understand that University of Co= lorado does not carry or provide health or accident insurance that responds to inj= ury or illness as a result of my/his/her participation in this Activity.

Participant Name_____________________ Signature_______________________ Date_______

Parent or Guardian (if participant is under 18 yrs. old)_______________= _________ Date_______

Mail Completed Registration Form and Ch= eck to:      &n= bsp;                  =         =     Frozen Foot
             &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;        PO Box 7042, Golden, CO 80403
      www.FrozenFoot5K.com        =             &nb= sp;            =             &nb= sp;            =             &nb= sp;            =             =                 Please make checks payable to CU Tri Team

www.cutriteam.com = = &nb= sp; = &nb= sp; = =

Questions?Concerns? Contact Corey at corey.hazek= amp@colorado.edu or 561-716-0120

University of Colorado

Release from Responsibility, Assumption of Risk and Wai= ver

&nb= sp;

Name_________________________________ = &nb= sp; Date______________________

I exercise my own free choice to participate in = the above designated Activity. I understand and assume all associa= ted risks. I agree to assume all = risk of personal injury or loss, bodily injury (including death), damage to or l= oss or destructions of any personal property including falls, contact with other participants, effects of weather, traffic and road conditions occurring in connection with or arising out of participation in the

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Frozen Foot 5k Race on February 21, 2010 <= span style=3D'font-size:10.0pt;mso-bidi-font-size:12.0pt;mso-bidi-font-family:Ar= ial'>

= &nb= sp; = &nb= sp; (Activity Name)

I hereby release and discharge, indemnify and ho= ld harmless the Regents of the University of Colorado, and their member office= rs, agents, employees and any other persons or entities acting on their behalf,= and the successors and assigns for any and all of the aforementioned persons and entities, against all claims, demands, costs and expenses, and causes of ac= tion whatsoever, either in law or equity, arising out of or in any way connected with any loss and/or bodily injury and/or disability, arising from my participation in the Activity.

&nb= sp;

In the event of an emer= gency, I grant the University of Colorado permission to authorize emergency medical treatment for ______________________________, (participant) for the duratio= n of his/her participation in this Activity.&nb= sp; I understand that Universit= y of Colorado does not carry or provide health or accident insurance that respon= ds to injury or illness as a result of my participation in this Activity.=

The official race director reserves= the right in any event of emergency or local or national disaster to cancel the race or to change the day and/or time to a later day and that in the event = of cancellation or change there is no refund of entry fees.<= /i>

I have had sufficient time to review and seek explanation of the provisions contained above, have carefully read them, understand them fully, and agree to be bound by them. After careful deliberation, I voluntarily give my consent and agree to this Release, Assumption of Risk a= nd Waiver.

If the participant is under<= /span> 18 years of age, the parent or guardian in consideration of this request accepts the above terms and grants permission for the student’s participation.

________________________________________________= ____________________________

Participant Signature (Parent or Guardian if under 18) = &nb= sp; = &nb= sp; = &nb= sp;

Date _____________________________________________