St. Patrick’s Day Run for the Gold 5K

Family Fun Run/Walk

                              Saturday March 20^th, 2010

 Dublin, TX

8:00am at Grafton/Elm Intersection

This is the first annual Run for the Gold 5K Family Fun Run/Walk presented by Titan Fitness. Come and enjoy St. Patrick’s Day in Dublin, TX and start your celebration off right by participating in our Fun Run/Walk 5K on Saturday March 20^th at 8:00 am.

Registration Form (each participant must complete a separate form and sign):

First Name: _______________________Last Name: _________________________________

Address: ____________________________________City/ State: ________________________

Phone Number: ________________________Age: __________ Male ____ Female ______

Email: ___________________________________________________________

Would you like to know about future events by Titan Fitness?   Y     N

T-shirt size (Circle One)   S    M     L     XL    XXL    XXXL

Entry Fee:  $25 per adult and $15 per kid(under 12) if your registration and payment are received by March 5, 2010 and you will be guaranteed an official race T-shirt. After March 5, 2010, until 7:30am on race day, the entry fee is $30 per adult and $20 per kid(under 12) and T-shirts are on a first-come, first-serve basis. Please make checks payable to Titan Fitness.

        Mail in Entry Form:                          Drop off/Register at:

Titan Fitness                                              Titan Fitness

     275 Mitchell Road               OR                          125 South Patrick

     Lorena, TX 76655                                       Dublin, TX 76446

Call 254.445.3001 or visit www.TITANFITNESSONLINE.com for more information.

RACE WAIVER AND RELEASE (MUST BE SIGNED BY EACH PARTICIPANT): In consideration of your acceptance of my entry, I, intending to be legally bound, for myself, my heirs, executors and administrators forever waive release and give up any and all claims, demands, liability, damages, and

expenses of any kind whatsoever, including personal injuries to me or wrongful deaths, against Titan Fitness-Dublin, LLC, the city of Dublin, and their officers, directors, employees and agents, subcontractors, sponsors and volunteers, which may arise from my participation in the Run for the Gold 5K Family Fun Run/Walk or while traveling to or from the event, even if caused in whole or in part by the negligence or other fault of the parties or person or persons I am hereby releasing, by the dangerous or defective condition of any property or equipment owned, maintained or controlled by them and/or because of their liability without fault. I FULLY UNDERSTAND THAT I AM GIVING UP IN ADVANCE ANY RIGHT TO SUE OR MAKE ANY CLAIM AGAINST THE PARTIES I AM RELEASING IF I SUFFER SUCH INJURIES OR DAMAGES EVEN THOUGH I DO NOT KNOW WHAT OR HOW EXTENSIVE THOSE INJURIES AND DAMAGES MIGHT BE AND AM VOLUNTARILY ASSUMING THE RISK OF SUCH INJURIES AND DAMAGES. I will assume my own medical and emergency expenses in the event of an accident of other incapacity or injury

resulting from or occurring in my participation. I grant full permission to any and all organizations which obtain photographs, motion pictures,

videotapes, recordings, or any other record of the event to use them for any purposes whatsoever, and for an unlimited amount of time. I understand

the entry fees to be non-refundable and non-transferable for any reason.

Participant Signature:   ___________________________________ Date: ____________________

Parent/Guardian Signature(for entrants under age 18): __________________________Date:_______