First Name Last Name
Address
City State Zip Code
e-mail Join PCTR E-mail List
Phone Age Sex Male Female
T-Shirt Small Medium Large Extra Large (Optional item, in lieu of cotton t-shirt) No - $0 Event Dri-release Shirt - $10 PCTR Hat - $7 PCTR Socks - $5 PCTR Tote Bag - $5 No PCTR Item - ($5)
Event 8 Km - $25 8 Km - $24 (5% Discount, > 3 PCTR Events) 16 Km - $35 16 Km - $33 (5% Discount, > 3 PCTR Events) 25 Km - $35 25 Km - $33 (5% Discount, > 3 PCTR Events) 50 Km - $50 50 Km - $48 (5% Discount, > 3 PCTR Events)
# of prior organized trail runs? How did you hear about PCTR?
I know that trail running is a potentially dangerous activity. I assume all risks associated with participating in this trail run, including but not limited to, medical, following course markings and directions, falls, contact with other runners, the effects of the weather, the conditions of the roads and trails, and traffic on the course, all such risks being known to and appreciated by me. Having read this waiver and knowing these facts, and in consideration of acceptance of my application for Pacific Coast Trail Runs (PCTR) activities, I, for myself and anyone entitled to and on my behalf, waive and release PCTR from all claims or liabilities of any kind arising out of my participation in this run even though that liability may arise out of negligence. I grant full permission to PCTR to use photographs or any other record of this event, including written comments or articles by me, for any legitimate purpose. This event is sanctioned by USA Track & Field. I understand that entry fees are non-refundable and non-transferable to future PCTR events.
Signature Date
Print Form
Make checks payable and mail to:
Pacific Coast Trail Runs
22 Fairway Place
Pleasant Hill, CA 94523