Mail to:
Newport Marathon
PO Box 1313
Newport, OR 97365
PACKET
PICKUP: See event Web site for details
Event (Choose One)
Marathon
Pasta Dinner Tickets (Choose One)
Pasta Dinner Tickets
First
Name / MI / Last Name
Street Address
City
State/Province
Zip/Postal Code
Country
Birthdate - mm/dd/yy
Age on Race Day
Gender
Phone
Email
Special Divisions
T-Shirt
Size (included with entry fee)
Number of Marathons Completed / PR
WAIVER MUST BE READ, SIGNED AND MAILED WITH ENTRY
WAIVER OF LIABILITY: In consideration of your
accepting this entry, I, the undersigned, intending to be legally bound hereby, for myself, my family, my heirs, executors,
and administrators, forever waive, release and discharge any and all rights and claims for damages and causes of suit or
action, known or unknown, that I may have against the Newport Marathon, The Newport Booster Club, The City of Newport,
Lincoln County, Oregon State Parks and Recreation Department, any and all political entities, Oregon Coast Bank, all
independent contractors and construction firms working on or near the race course, any and all business and residential
owners located on the race course, all persons working with or associated with the Newport Marathon including but not limited
to all committee persons, organizers, race directors and volunteers and sponsors of the Marathon and any related Marathon
events and their officers, directors, employees, agents and representatives, successors, and assigns for any and all injuries
suffered by me in this event. I attest that I am physically fit, am aware of the dangers and precautions that must be taken
when running in warm or cold, wet or dry conditions and have sufficiently trained for the completion of this event. I also
agree to abide by any decision of an appointed medical official relative to my ability to safely continue or complete the
Run/Walk. I further assume and will pay my own medical expenses in the event of an accident, illness, or other incapacity
regardless of whether I have authorized such expense. Further I hereby grant full permission to the Newport Marathon and or
agents authorized by them to use any photographs, videotapes, motion pictures, recording or any other record of this event
for any legitimate purpose at any time.
I HAVE READ THIS WAIVER CAREFULLY
AND UNDERSTAND IT.
Type Full Name
Signature X ___________________________________________________________________
(Signature of Parent or Legal Guardian if participant is under the age of
18)
Date________________________________________
Amount Enclosed
Add $10.00 Data Entry Fee