2011 San Diego 100 Mile Endurance Run Application
THIS ENTRY CONTAINS A LIMITATION ON
YOUR LEGAL RIGHTS - READ IT! I wish to
enter and participate in the San Diego Endurance Run on June 11-12, 2011.
I accept the rules, conditions, and regulations of the event and will
comply with them. I acknowledge that I am responsible for my pacers
and crew, and can be disqualified for their violations of the rules. I
am aware that a 100 mile trial run is extremely difficult and
hazardous for even well conditioned athletes under the most favorable
of conditions. This run covers difficult mountainous terrain and spans
great extremes of altitude and temperature. I am aware that I should
not participate in this event unless: a) I am in excellent physical
condition, b) I have previously run ultra-marathon distances on rugged
trails, and, c) I have recently had a complete physical examination. I
am also aware that I may be exposed to physical injury from a number
of natural factors including snow and other hazards on the trail, lack
of water, communicable diseases, wildlife, hazards of vehicular
traffic, and other hazards attendant to running along or across
roadways during the day or at night. I understand and accept that the
risks include the fact I may become injured or incapacitated in a
location where it is difficult or impossible for the Run's management
to get required medical aid to me in time to avoid additional physical
injury or death. Knowing these facts, nevertheless, in consideration
of the Run's accepting this entry, I hereby for myself, my heirs,
executors and administrators, waive, release and discharge SURF Inc. a
501 (c) (3) not for profit corporation, its officers, directors, and
members, Rancho Cuyamaca & Anza-Borrego State Parks, USDA Forest Service, ARES, SARS,
SDMRT, any official sponsor entity, and the officers, trustees,
directors, shareholders and/or members, agents, employees, and
families of each, all medical and other personnel assisting with the
Run, or any of them and any other person connected with this running
event, their representatives, successors and assigns; from any and all
rights, claims or liability for damage for any and all injuries to me
or my property, or for damage caused by me or by any one else
(including Acts of God), arising out of or in connection with my
participation in this event. I further agree that I will defend and
indemnify the above released parties against all claims, demands and
causes of action or other proceeding brought by or prosecuted for my
behalf contrary to this agreement. This release extends to all claims
of every kind and nature whatsoever, whether known or unknown, and I
expressly waive any benefits I may otherwise have under section 1542
of the Civil Code of California, otherwise protecting me from the
release of unknown claims. THE
Refunds less $50 administrative fee up to May 1, 2011. NO REFUNDS AFTER MAY 1, 2011.
Print Full Name ________________________________ Date ____________________
Signature ___________________________________________________________
Email Address (PLEASE PRINT LEGIBLY): ______________________________________________
Phone(______) _______________________
Gender__________ Date of Birth: ______________
Home
Address ____________________________________City _____________________
State ________ ZIP _________ E
-mail:___________________________________
Qualifying Race (minimum - sanctioned 50 mile race
completed between June 1, 2009 and Feb 1, 2011 under 13 hours, or
completion of a 100 miler at any time.)
Name of
Qualifying Race_______________________________________________
Date _____________ Distance__________________ Time
____________________
How many San Diego 100s have you completed ? ______________How many ultras have you completed?___________________
NOTE: If you have not completed a 100 miler prior to this event, you must have a pacer to accompany you for the night section you will be running for safety reasons.
T-SHIRT SIZE (Unisex): (circle) XS S M L XL
SOCK SIZE: (circle) Small Medium Large X Large
RACE ENTRY FEE: $195:
$ ______________
CAMPING SITE ($10 per night per tent) Friday night: $ ______________
Saturday night: $ ______________
RV SITES: $20 per night Friday night: $_______________
Saturday night: $ _______________
Extra Pre-Race Pasta Dinners $10 each (free for runners):
$ ______________
TOTAL FEES
$
______________
Please enclose all fees and make your check payable to Scott Mills.
Mail to: SCOTT MILLS, 4170
Andros Way, Oceanside, CA 92056