2020  ELLERBE   MARATHON  MAILABLE  ENTRY   FORM
                       Paper mail-in entry will be unavailable after December 31
               
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 28
6:00-7:30 p.m.                  Packet pick-up at the Spring House
Saturday, February 23
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
10:00 a.m.                        Lunch begins at the Rescue Squad Building

                              
       
This entry is for the  _____Marathon          ______Half Marathon

                                              Please enclose check for $60                                               

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.?_______   Are you a Mangum Track Club member   yes___ no___

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, and
discharge 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.

Participant Signature____________________________________________________Date__________

Parent's Signature if participant under 18_________________________________________________