NEWPORT MARATHON / HALF MARATHON 2017 Entry Form

Saturday, June 3, 2017

Newport, OR

www.newportmarathon.org

run@newportmarathon.org

CHIP TIMING!

Instructions

Type in your information in the  blanks provided.
Print entry form and SIGN WAIVER (Entry will not be accepted without the signed waiver)

Make Checks Payable to:

Newport Marathon

(The Newport Marathon/Half Marathon is a nonprofit event. All proceeds help fund school athletics in Newport Oregon.)

Mail to:
Newport Marathon

PO Box 1313

Newport, OR 97365

PACKET

PICKUP: See event Web site for details

Event (Choose One)

Marathon

MARATHON RUNNERS start time – 7:00 am
MARATHON WALKERS start time – 6:00 am

–Newport Marathon Run – $90 (before 4/1/17)Newport Marathon Walk – $90 (before 4/1/17)Newport Marathon Run – $100 (before 5/1/17)Newport Marathon Walk – $100 (before 5/1/17)Newport Marathon Run – $110 (5/1/17 until race fills)Newport Marathon Walk – $110 (5/1/17 until race fills)

HALF MARATHON start time – 7:45 am

–Newport Half Marathon – $75 (before 4/1/17)Newport Half Marathon – $80 (before 5/1/17)Newport Half Marathon – $85 (5/1/17 until race fills)

 

Pasta Dinner Tickets (Choose One)

Pasta Dinner Tickets

NONEOne ($10.00)Two ($20.00)Three ($30.00)Four ($40.00)

First Name / Last Name

Street Address

City

State/Province

Zip/Postal Code

Country

Birthdate – mm/dd/yy

Age on Race Day

Gender
–FemaleMale

Phone

Email

Special Divisions
Hercules (males 190lbs and over) and Athena (females 145lbs and over)

Sign up at Packet Pick Up after weighing in.

T-Shirt Size (included with entry fee)

–Men’s SmallMen’s MediumMen’s LargeMen’s XLWomen’s SmallWomen’s MediumWomen’s LargeWomen’s XL

 

Number of Marathons Completed / PR (Marathon runners only)

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/Half 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