2018  ELLERBE   MARATHON  MAILABLE  ENTRY   FORM
                  Mailed entries must be post marked no later than February 10
PLEASE GO TO OUR WEBSITE AND READ THE COMPLETE INFORMATION AND        
UPDATES FOR THE ELLERBE MARATHON BEFORE SUBMITTING YOUR ENTRY
DOUG DAWKINS, Race Director   910-206 2095 call or text    E-Mail  doug@theboogieraces.com

SCHEDULE OF EVENTS
Friday, February 23
5:00-8:00 p.m.                            Packet pick-up at the Spring House
Saturday, February 24
6:30-7:30 a.m.                            Race day registration and packet pick-up at       
                                              Ellerbe Rescue Squad Building
7:45 a.m.                                    Pre-race briefing at the start line
8:00 a.m.                                    Start of marathon and half marathon
11:00 a.m.                                  Lunch begins at the Rescue Squad Building


This entry is for the  _____Marathon          ______Half Marathon

Entry fees are the same:        $50 entry postmarked before November 1, 2017
for both events:                      $60 entry postmarked November 1 thru December 31
                                          $65 January 1 and after. Paper registration closes February 10

Send completed entry and check to:  Ellerbe Marathon P.O. Box 96 Ellerbe, N.C.  28338
                                
Name (please print)________________________________________________________________________

Email_____________________________________Phone__________________________________________

Address________________________________________City_________________State________Zip_________

Sex________Date of Birth____________Age Race Day________Do you live in Richmond County, N.C.?_______

Shirt size (circle one)    S      M       L       XL       XXL

Ellerbe Marathons completed________Ellerbe Half Marathons completed________

Emergency contact_____________________________________Phone________________________________

Waiver and release:   I understand and agree in consideration of being permitted to participate that me (the
participant), my heirs, personal representatives or assigns of me do hereby release, waive, discharge and
covenant not to sue the Race Director, Assistant Director, Wilson Timing, any of its owners, officers,
representatives, any and all event directors or coordinators, The Ellerbe Rescue Squad or any of its members,
any and all event volunteers or USA Track and Field from any and all liability from any and all claims arising from
participation in the Ellerbe Marathon or the Ellerbe Half Marathon.  I realize that participating in a marathon is a
sometimes risky and potentially hazardous endeavor and assume all responsibilities for my participation.  I certify
that I am properly trained and medically able to participate in this event.  I realize that the race director has the
right to refuse any entry and that decisions rendered by the race director whether in participation or finish results
will be final. My signature below verifies that I have read all pertinent entry information and this waiver and agree
to abide by all rules and guidelines presented in the entry information and also to accept any changes or
decisions rendered by the race director before or during the event.

Signature_______________________________________________________Date_______________________
                (Parent or guardian if under 18)