Fill out form below (please print) and include nonrefundable $20 fee.                                     Mail to:  Rapides Junior Runners                                     PO Box 4814                                            Pineville,LA 71361         Race day registration is $30 and will end 15 minutes prior to the start of the race! Prizes will be awarded to the top three finishers in each age group. Age groups - 5 and under,  6-7,  8-9,  10-11,  12-13,  14-16 Every race participant will get to pick a prize from the Rapides Junior Runners shop! _______________________________________________________________________________ Name:_______________________________________________ Address:_____________________________________________ _____________________Zip:________Phone:______________ email:_______________________________________________ age:_______Birthdate:___________________Sex:   M      F I know that participating in a running event is a potentially hazardous activity.  I should not enter and participate unless I am physically fit and properly trained, and by my signature, I certify that I am medically able to perform this event.  I agree to abide by any decision of a race official relative to any aspect of my participation in this event including the right of any official to deny or suspend my participation for any reason whatsoever.  I assume all risks associated with running in this event, including but not limited to: falls, contact with other participants, effects of weather, including high heat and/or humidity, traffic and the condition of the road, all such risks being known and appreciated to me.  I understand that skateboards, scooters, rollerskates or roller blades, animals and radio headsets are not allowed in the running event and I will abide by these guidelines.  Having read this waiver and knowing these facts and in the consideration of your acceptng my entry, I for myself and anyone entitled to act on my behalf, waive and release Rapides Junior Runners, volunteers, and any and all sponsors, their representatives and assessors from any claims or liabilities of any kind arising out of my participation in his event, even though that liability may arise out of negligence or carelessness on the part of the person named in this waiver.  I release the rights to any and all photographic material, including film and computer information. Parent signature:_______________________Date:_________