Bear Water Run Registration Form       September 9, 2017

WAIVER. Knowingly and at my own risk I do hereby apply to enter an athletic contest. I hereby agree that I release and discharge the White Bear Lake Lions, and other parties associated with the Bear Water Run from all claims, demands, injuries, damages, actions or causes of action from all acts of active or passive negligence on the part of such corporations, organizations, clubs there servants, agents or employees, and hereby assume all the risks associated with my participation in the event. Further, I hereby grant full permission to any and all of the foregoing to use my name, likeness and voice, as well as any photographs, videotape, motion pictures, recordings and any other record of this event in which I may appear for any legitimate purpose including broadcast of the event, the reuse in any media of this broadcast and in advertising and promotion.

Signature
(by parent or guardian if
participant is under 18) ___________________________________________________

PRINT OUT THIS ENTRY FORM AND MAIL IT WITH FEE BY SEPTEMBER 6 TO

Make check payable to The White Bear Lake Lions Club

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