First Name:      Last Name:   

Address:  

City:   State:    Zip:  

Email:   Phone No.  

Sex:       ? Female Male       Age day of race:     

I am an athlete, parent, sibling, or coach of   Cross Country team.
*Please differentiate between boys and girls teams. For example, Westerville North Boys or Westerville North Girls

Waiver:    In consideration of the acceptance of this entry, I hereby waive and release any and all rights and claims for damages that I or my heirs may have against the City of Dublin, the Columbus Running Company, race sponsors and volunteers. I certify that I have properly trained for this event and am medically able to participate.  By selected "I Agree" below, you are authorizing your signature to be taken electronically, which holds the same value as your written signature.     

Waiver Signature:                            I Disagree I AGREE