Darkside Distance Festival Registration

 

Submit the form below only after payment via PayPal has been processed.
Please make sure to mark the appropriate field if you chose to mail us a check for this registration.

Please note that your registration is not completed until payment is received.

 

Your Name (Required)

Your Age (Required)

Your Gender (Required)
malefemale

Your Shirt Size (Required)

Your Email (Required)

Phone (Required)

Your Full Address (Required)

Emergency Contact Info* (Required):




Your Dietary Needs: (Required)
vegetarianvegangluten-freeno-preferenceother


Confirm race/races registered for: (Required)
1-Day Fri1-Day Sat1-Day Sun2-Days Fri~Sat2-Days Sat~Sun3-Days Fri~Sun

Event Plan [Specify what you plan to accomplish during this time]: (Required)

Senoia 60Senoia 48Senoia 36Senoia 24Running Dead 100MRunning Dead 50MRunning Dead 50KRunning Dead 25KDarkside MarathonDarkside Half-Marathon


Select Registration Payment Method (Required)
PaypalSnailmail

Print Snailmail Registration here and send check or money order payment to the address provided.


Liability and Publicity Release
(Information in parentheses applies only if participant is under 18 years of age.)

In consideration for allowing me (my child) to participate in the Darkside Distance Festival, I, the undersigned, intending to be legally bound, waive and release, for (my child) myself, my heirs, executors and administrators, any and all rights and claims for property damage and personal injury, including death, which I (my child) may have against the coordinators and volunteers involved with this event (as well as their representatives, successors and assignees) arising from my participating in this event. I verify that I have full knowledge of the rigors of this race and the risk involved in participation, and I am (child is) physically fit and have (has) sufficiently trained to complete this event. I (on behalf of my child) hereby grant permission to the event coordinators to use all information submitted in my application and my photograph and any other record of this event including pre-race and post-race publicity.

Senoia/Haralson/Coweta County
RELEASE AND WAIVER OF LIABILITY

The undersigned, hereby acknowledges a desire for members(s) of the family to participate in an event in Haralson and Senoia of Coweta County. The undersigned further acknowledges that such participation, including travel to and from events, involves an inherent risk of physical and mental injury, but acknowledges that participation is voluntary and agrees to assume any and all risks.
The undersigned, further acknowledges and agrees that Haralson, Senoia and Coweta County employees, and agents assume no responsibility for personal injuries and/or property damage which might be suffered by the family member(s) during any and all participation and does hereby expressly release these two Cities, City council members, employees, and agents from any and all liability relating to any such injuries and/or damage.

Your Initials (Required)