Gazelle Sports Dirty Herd Sign In

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This form is a sign in for all Gazelle Sports Dirty Herd Runs and Events. This form is required to participate in Gazelle Sports Dirty Herd.

Name (First and Last) *

Phone Number *

Emergency Contact Name *

Emergency Contact Phone Number *

Any medical conditions you want us to be aware of in case of an emergency?

Run Community Waiver - Box must be checked in order to participate. Checking this box acts as your signature. *

I know that participating in an event is a potentially hazardous activity, which could cause injury or death. I will not enter and participate unless I am medically able and properly trained, and by my signature, I certify that I am medically able to perform this event, and am in good health, and I am properly trained. I agree to abide by any decision of an event 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 attest that I understand the rules of the event and agree to abide by them. I assume all risks associated with running in this event, including but not limited to: falls, contact with other participants, the effects of the weather, including high heat and/or humidity, extreme cold and/or ice, traffic and the conditions of the road, all such risks being known and appreciated by me. I understand that bicycles, skateboards, baby joggers, roller skates or roller blades, animals, and personal music players are not allowed on the group runs and I will abide by all event rules. Having read this waiver and knowing these facts and in consideration of your accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release Gazelle Sports, and the Road Runners Club of America, all event sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event, even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I grant permission to all of the foregoing to use my photographs, motion pictures, recordings or any other record of this event for any legitimate purpose and for Gazelle Sports to communicate with me about future events/promotions.

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