Danville Half-Marathon Entry Form
Register online or fill out the form below, print it out, and mail to:
DCC, Attn: V. Decker, 1008 South Main Street, Danville, VA 24541
Enter the information on your computer screen and print -or- Print out first and fill in the form by hand
Half-Marathon Pricing: $50 through race day.
MAKE Checks payable to DCC Educational Foundation
First Name Last Name
City State Zip
Age on Race Day Date of Birth (MM/DD/YY)
Shirt Size: Small Medium Large Extra Large
Gender: Male Female
Half-marathon predicted time: hour(s) and minutes (3-hour limit)
I understand that participating in this event is potentially hazardous, and that I should not enter and participate unless I am medically able and properly trained. In consideration of the acceptance of this entry, I assume full and complete responsibility for any injury or accident which may occur while I am traveling to or from the event, during the event, or while I am on the premises of the event. I also am aware of and assume all risks associated with participating in this event, including but not limited to falls, contact with other participants, effect of weather, traffic, and conditions of the road. I, for myself and my heirs and executors, hereby waive, release and forever discharge the race directors, Danville Community College, the City of Danville, the State of Virginia, The Danville Running & Fitness Club, Virginia Bank & Trust, all of the event organizers, sponsors, promoters, RaceIt.com and each of their agents, representatives, successors and assigns, and all other persons associated with the event, for my all liabilities, claims, actions, or damages that I may have against them arising out of or in any way connected with my participation in this event. I understand that this waiver includes any claims, whether caused by negligence, the action or inaction of any of the above parties, or otherwise. I understand that the entry fee is non-refundable and non-transferable. I hereby grant full permission to any and all of the above parties to use any photographs, videotapes, motion pictures, web site images, recordings or any other record of this event.
Signature ____________________________ Date: _________