Kootenai River Run Entry Form

Send completed form and check or money order to:

Kootenai River Run, C/O Jim Cadnum, 3178 District Two Road, Bonners Ferry, ID  83805

Please make checks payable to Kootenai River Run.

Last Name ______________________­­ First Name ________________ Sex ___  Age on race day ____

Address _________________________________ City ____________________State ___ Zip _______

Phone Number _____________________  E-mail address _______________________________

Race Entered: 5K___   10K___

Where did you learn of our run? ___________________________________________________

Shirt size:        S     M     L    XL   XXL   Youth 10-12    No Shirt     (please circle your choice)

To qualify for awards, you must complete the course that is checked.

Waiver: I know that running a road race is a potentially hazardous activity.  I also know that, although police protection will be provided, there will be 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 condition of the roads.  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 waive, release, and discharge Kootenai River Run, race officials, volunteers, and all sponsors, including their agents, employees, assigns of anyone acting for or on their behalf, from all claims of liability for death, personal injury, or property damage of any kind arising out of my participation in this event.

Applications for minors will be accepted only with a parent’s or guardian’s signature.

Signature ______________________________________________   Date _________________

Signature of parent or guardian if runner is under 18 _______________________________

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