Railsplitter Run

To apply online please complete the form below.  When you submit your application you will be taken to PayPal to process your registration fee. Please note you will have to manually key in your total amount once you reach PayPal and it is not necessary to have a PayPal account to complete the transaction. Failure to complete the transaction will result in your application being rejected. 

 
 

Entry fee $10 in advance $15 the day of the race

Name Age
Sex Telephone
Address Email

Please select which event you are entering: One Mile Run/Walk $10 pre-register $15 Day of Race
5K Run $10 Student $15 pre-register $20 Day of Race

Shirt Size:
Youth: Medium Large
Adult: Small Medium Large X-Large XX-Large

RELEASE OF RESPONSIBILITY
(THIS FORM MUST BE COMPLETED & SIGNED BEFORE RACE.)

In consideration of your accepting my entry, I, intending to be legally bound, do hereby for myself, my heirs, my executors, administrators, or assigns, waive and release forever any and all rights and claims for damages I may accrue against any and all persons, businesses, agencies, and other participants including but not limited to Lincoln Days, Inc., its officers, Board of Directors, organizers, sponsors workers, officials, volunteers, the City of Hodgenville, LaRue County, Kentucky and all others involved with this athletic event, their successors, representatives and assigns, growing out of my participation in any Lincoln Day race events, including travel to and from Hodgenville, Ky.

I certify that I have full knowledge of the risks involved in a race of 1 (one) mile or the 5K and that I have achieved a level of physical fitness required. I certify by my signature that I am eighteen years of age, or parent or legal guardian of a minor, who enters this race with my permission, and I assume full responsibility and liability for all persons whose names are listed on this form.

Signature Date 1/6/2009

 

 
 
 
 

 
 
 
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