2004 RunBig Chicago Race Circuit Registration Form

Circuit you are registering for (check one or both):

COMPETITIVE RACE CIRCUIT MULTISPORT RACE CIRCUIT
Race circuit participation requires current Run Big Chicago membership
RunBig Chicago Multisport Club membership #

If you are not a member of RunBig Multisport Club, please go here to sign up:

http://www.signmeup.com/29480

First Name Last Name

Address

City

State

zipcode

email

home phone work phone

Gender: Male Female

Age Birthdate (mm/dd/yyyy)

Age and Weight Divisions (open and masters)
MEN - A (170-184) B (185-199) C (200-224) D (225+ lbs.)
WOMEN - A (135-144) B (145-154) C (155-169) D (170+ lbs.)
Divison: A B C D

Waiver
I know that any events I enter carry the risk of personal injury or damage. I am aware that running, fitness and multisport events require advance training, and I certify that I am physically fit for these events. I hereby waive and forfeit all rights I may have to file suit or make claims against RunBig Chicago Multisport Club, any sponsoring organizations, and all persons connected with these events for injuries I may suffer at these events or any other activities organized or sponsored RunBig Chicago Multisport Club.

AGREE TO WAIVER: YES NO (unchecked waivers will not be considered as valid)

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