Name:
Address:
Address:
City:
State:
Phone:
E-mail:
Zip:
Male
Female
Signature:
IIn consideration of the foregoing, I, for myself, my heirs, executors and administrators, waive and release any and all rights and claims for any claims damages I may have against any of the sponsors, volunteers, organizers, City of Shelbyville, Blue River Soccer Association, Shelbyville Parks and Recreation, and Energy2Action, LLC, for any and all claims of damages, demands or loss actions whatsoever which may arise as a result of my participation in this event. I understand and acknowledge that participating in this run/walk event may expose me to dangers from both known and anticipated risks. I understand that the course is not closed to traffic and that I could be at risk from traffic, other runners and cyclists, bad weather, ice, wet roads and rough terrain along the course. I acknowledge that some sections of this run course might be off road or rough road and may contain areas where I will be at risk of tripping and falling. I attest and verify that I am physically fit and have sufficiently trained for the completion of this event and my physical condition has been verified by a licensed medical doctor. I understand that this event may be canceled or delayed for any legitimate purpose or reason and that my entry fee will not be refunded under those circumstances or for any other reason. Further, I grant full permission to any and all of the foregoing to use my likeness for any legitimate purpose whatsoever.
T-Shirt Size:
Age on race day
Make Checks Payable to: Energy2Action, LLC
THE MELT DOWN
Three 5K's + One Day = The Melt Down
July 20, 2024
8:00 A.M. - Race #1
9:00 A.M. - Race #2
10:00 A.M. Race #3
(Do one, two or all three)
Blue River Memorial Park
1021 E. Morris Avenue
Shelbyville, IN 46716
Print, fill out and mail to:
Energy2Action, LLC
1223 Oak Lane
Shelbyville, IN 46176
Pre-Registration is due by 7/15/24
Races must be completed in order (no fresh runners in Race #2 or #3 and you can't skip #2 and do #3). If you sign up for more than one race, you are NOT obligatged to complete all three races. If you decide not to participate in #2 or #3 - no problem! We don't want you to have a Melt Down! (or do we?)
Which Races do you plan to run/walk?:
