Name:*
Age:
Parent's Name, if child:
Sex of participant:*
Address:*
Phone:*
Other Phone:
Email Address:
I want to participate in the:*
Shirt Size (Please select one):*
Which group/organization are you signing up with?
If you are signing up your entire family, please put each of their names along with their ages, sex, t-shirt size and which race they will be running or walking, in the below box.
Please acknowledge you have read and agree to the following by checking the box below: The undersigned shall indemnify, hold free and harmless, assume liability for, and defend Mary Immaculate Catholic Church, its agents, servants, employees, officers, and directors from any and all costs and expenses, including but not limited to, medical fees, attorney's fees, discovery costs, court costs, and all other sums associated with any claim or action founded thereon, including those arising or alleged to have arisen out of treatment of self and aforementioned minor. We also release Mary Immaculate Catholic Church, the Dallas Catholic Diocese, and any agents of the church of any liability incurred due to self or aforementioned minor's use of real or personal property belonging to Mary Immaculate Catholic Church, its agents, employees, or volunteers. *
