Application and Waiver  Oriflamme 50K March 19, 2011 / Application / Waiver Name ___________________________________________________________________ Address _________________________________________________________________ City _______________________________________ State ___________ Zip___________ Phone _____________________ Email (print clearly please) __________________________________________ Age on race day _________ Sex: M or F Technical T-Shirt Size: XS S M L XL Entry Fee: $75 postmarked on or before February 28, 2011. $90 postmarked between March 1 and March 12, 2011. $10 discount for active military and their immediate family. NO ENTRIES ACCEPTED AFTER MARCH 12. NO DAY OF RUN REGISTRATION. Make Checks payable to: Oriflamme 50K Anza Borrego State Park Permit for this event is conditional and may be cancelled anytime up to race weekend. If the race is cancelled, refund or rollover of entry fees to another date may not be guaranteed. THIS ENTRY CONTAINS A LIMITATION ON YOUR LEGAL RIGHTS - READ IT! I wish to enter and participate in the Oriflamme 50K Endurance Run on March 19, 2011. I accept the rules, conditions, and regulations of the event and and will comply with them for myself and crew knowing that I can be disqualified for violations of the rules. I am aware that a 50 kilometer trail run is extremely difficult under the most favorable of conditions. This run covers difficult mountainous terrain with extremes of temperature and altitude. I am aware that I shall not participate in this event unless: a) I am in excellent physical condition, b) I have previously run ultra-marathon distances on rugged trails, and c) I have recently had a complete physical examination. I am also aware that I may be exposed to physical injury from a number of natural factors and/or hazards on the trail such as but not limited to lack of water, communicable diseases, wildlife, hazards of vehicular traffic, and other hazards attendant to running along or across trails and roadways. I understand and accept that the risks include the fact I may become injured or incapacitated in in a location where it is difficult or impossible for the Run's management to get required medical aid to me in time to avoid additional physical injury or death. I hereby for myself, my heirs, executors, and administrators, waive, release, and discharge the Oriflamme 50K Run and West Coast Ultra Runners, its owner, directors, employees, the Race Director, volunteers, and sponsors, the State of California, County of San Diego, Anza Borrego Desert State Park and/or families of each, all medical and others assisting with the Run, USA Track & Field, or any of them and any (including Acts of God), arising out of or in conjunction with my participation in this event. I further agree that I will defend and indemnify the above released parties against all claims, demands, and causes of action or other proceedings brought by or prosecuted for my behalf contrary to this agreement. This release extends to all claims of every kind and nature whatsoever, whether known or unknown, and I expressly waive any benefits I may otherwise have under section 1542 of the Civil Code of California, otherwise protecting me from the release of unknown claims. This entry is of and by the runner, who by his/her signature has verified acceptance of all risks and responsibility for his/her condition and welfare during this event. Signature _______________________________________________ Date ________________________ Emergency Contact _______________________________________ Phone _______________________ Mail Entries to: Oriflamme 50K c/o John Martinez P.O. Box 880695 San Diego, CA 92168-0695 | 
