Sagebrush Community Challenge/Scramble Registration Form

July 9th, 2011 10:00 AM

Wall/Franklin Downtown Bend

Please fill out this form to sign up for the Sagebrush Scramble or Community Challenge Sponsorships.

* = Required Field

Registration Information

Contact Information

Note: each participant must fill out a separate form.

Must register by June 1, 2011 to guarantee a t-shirt otherwise limited to availability.

Only walkers & runners are permitted. Please no dogs due to safety reasons, strollers are permitted, other wheeled transport (bikes, skateboards, rollerblades, etc,) are not permitted. Pick up your race packet on July 8th from 9AM to 5PM at FootZone in Downtown Bend or on the day of the race from 7:30 to 9AM at the corner of Wall and Franklin. Team size does not matter, but you have to stick together as a team. No splitting up - no cheating!

All event participants must agree to the terms of this waiver. If you are the parent/guardian of children entering the event, please provide those names on the waiver below.

In consideration of being allowed to participate in the Sagebrush Community Challenge/Scramble, I * (fill in name) acting for myself and (if applicable ) as the legal parent or guardian of (fill in name and age of participating minor) hereby releases and holds harmless and indemnifies Sagebrush, Inc., its employees, agents and volunteers including, but not limited to, all sponsors & organizers of the Sagebrush Community Challenge/Scramble from all claims, demands, suits, actions, charges, damages, judgments and liabilities, past, present, and future, known and unknown, whether for personal injury, property damage, death, emotional distress, medical expenses, economic or noneconomic loss, and any other claims arising from, or in any way related to, my and/or my child's participation in the Sagebrush Community Challenge/Scramble including, but not limited to, claims based on negligent or reckless conduct. I consent to, and permit and accept the responsibility for, emergency medical treatment in the event of injury or illness suffered by myself and/or my child. I grant Sagebrush, Inc. the right to use, incorporate and publish, in whole or part, photographs or videotape taken of myself and/or my child and waive any right to royalties or other compensation related to use of those photographs or videos. By submitting your registration, you agree to the terms of this waiver.

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