Name: 
      Address: 
         City: 
        State:    Zip: 
        Phone: 
       E-Mail: 
Date of Birth:    Age on race date: 
        Event: Men's Estimated time 5K Women's 5K
       Gender: M F
    Entry Fee:  $10 adult before 8/1  $13 between 8/1 and 8/15 $15 race day
 T Shirt Size: S M L XL
                Is this your first racing season?
         Club: PGRC Other None

Waiver Must Be Read and Signed Before Mailing:

I know that running is a potentially hazardous activity and that I should not enter and run in this race 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 compete in the run. I assume all risks associated with running including, but not limited to, falls, contact with other participants, the effects of the weather, including heat and high humidity, and the condition of the path or road, all such risks being known and appreciated by me. Having read this waiver and knowing these facts, and in consideration of your acceptance of my enrollment, I, for myself and anyone entitled to act on my behalf, waive and release the Prince George's Running Club, the Maryland National Capital Park and Planning Commission, the Road Runners Club of America, the 94th Aerosquadron Restaurant, plus all event partners, sponsors, volunteers, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this race even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. If I am signing this waiver as parent or legal guardian on behalf of the minor(s) named above, I agree to be responsible for the conduct and safety of the minor(s), and I recognize and assume the risks described above on behalf of those minor(s).

_______________________________  _____________ _____________________________________
Signature                        Date          Parent's Signature if under 18