Registration for Individuals with 
Down Syndrome

Registration form for Individuals with Down Syndrome

Please fill out this form completely and submit it Southeastern Trial Runs. Select the race distance and initial the waver at the bottom. When finished, press the "Submit Button at the bottom of the page.
First Name
Last Name
Street Address
City
State
BY SIGNING THIS RELEASE YOU GIVE UP ANY CLAIM FOR INJURY OF ANY KIND AND CERTIFY YOU HAVE READ THIS WAIVER AND THAT YOU AGREE TO IT'S TERMS. In consideration of your accepting my entry, and intending to be legally bound for myself, my heirs, my executor, and my administrators, I hereby release and discharge the Ridge to Blazing Ridge Race, Southeastern Trail Runs, LLC, the Race Committee, organizers, sponsors, Oak Mountain State Park and each and every person and entity affiliated and associated with the Ridge to Blazing Ridge Race, Southeastern Trail Runs, LLC from any and all liability, rights and claims for damages I may have arising out of my participation in these events, and waive all rights I may have to any such claims. I attest that I am physically fit and have sufficient training for the completion of this event and that a licensed medical doctor has verified my condition. I acknowledge that the course is strenuous and is run on difficult terrain on back-country trails and on paved and unpaved roads in conditions that can change without notice at any time. I acknowledge that there are inherent risks associated with my participation in this event, and agree to pay all of my own medical and emergency expenses in the event of accident, illness or other incapacitation regardless of whether I have authorized such expenses at the time they are incurred. I also grant full permission to the race organizers and sponsors to use any photographs or other records of my participation in this event for any legitimate purpose. I further consent to the use of photographs, video, film and sound recordings of all race events for all legitimate purposes. I give permission to be contacted by interested media. 

 IN THE EVENT THAT A RUNNER REQUIRES EMERGENCY EVACUATION BY GROUND or HELICOPTER-AMBULANCE, THE RUNNER ASSUMES ALL FINANCIAL OBLIGATIONS CONNECTED WITH THIS SERVICE. Race management is NOT responsible for any debt incurred.

The race committee may decline to accept any application for entry for any reason. This application must be signed.
Entrants under 19 year of age and individuals with legal guardians must have the waiver agreement signed by themselves and their parent or legal guardian.

 SIGNATURE                                                                                                                                                        SIGNATURE: Date  

SIGNATURE OF PARENT OR LEGAL GUARDIAN 

Unsigned entries will not be accepted. Form must be signed by LEGAL GUARDIAN where applicable.
Runners Age Race Day
Runners Date of Birth
Phone Number
Emergency Contact Name
Emergency Contact Number
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Select 5K Race
Select 1 Mile BOO Fun Run
Select 10K Race