Turkey Trot Mail-In Registration
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Race # ________________________________ (official use only)

Mail-in deadline is Thursday, Nov. 12, 2009. One form per participant (photo copies are accepted).

Check appropriate spaces:
______1 Mile Gobbler $10 ($12 race day)
______5K Wingding $15 ($20 race day)
______5K Fun Run $15 ($20 race day)
______10K Turkey Trot $15 ($20 race day)

WFYRC member discount price
______5K Wingding $10
______5K Fun Run $10
______10K Turkey Trot $10

Pre-registration only. No discount on race day (must present membership card or register by mail.)

_____Check here if you are a wheelchair entry or will need any special assistance.

Name:_______________________________________________

Sex:____________Age on race day:_______________________

Phone: (______)_______________________________________

Address:_____________________________________________

____________________________________________________

City:________________________________________________

State:_____________Zip:_______________________________

Incomplete or unsigned forms will not be accepted.

Participant Waiver, please sign and read below.
I know that running in and volunteering to work at West Florida
Runners Club races are potentially hazardous activities. I should not enter and run, walk and/or volunteer unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run, walk and/or volunteer. I also agree that I may be examined and treated if necessary during the course of a race by qualified race personnel in the event medical problems of any cause arise. The race officials or the qualified personnel have the right to disqualify me and remove me from the race, if in their opinion, I may be suffering from a life threatening condition. I assume all risks associated with running in and volunteering for races including, but not limited to, falls, contact with other participants, the effects of the weather, including high heat and/or humidity, the conditions of the road and traffic on the course, all such risks being known and appreciated by me. Having read this waver and knowing these facts, and in consideration of your acceptance of my application for participation in races and/or
my volunteering, I, for myself and anyone entitled to act on my behalf, waive and release the West Florida Runners Club, the St. Petersburg Times, the City of Clearwater and all above mentioned officers and agents, all sponsors, their representatives and successors, including the Road Runners Club of America, its officers, directors, agents and employees, from all claims or liabilities of any kind arising out of my participation in events even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I also approve the use of my and/or dependent's picture taken before, during
or after the races for promotional use without further compensation.

Signature:_____________________________________________

Date:_________________________________________________

Parent of Guardian, if under 18: ___________________________________________________________

To register by mail, you must complete form and send a self-addressed, stamped, no. 10 legal size (9 1/2 x 4 inch) envelope with your check or money order payable to: Times Turkey Trot, Attn: Birchfalls, RR8, Box 8167B, Stroudsburg, PA 18360. Race numbers will be mailed after Oct. 20, 2009.