PRINT AND BRING TO RACE


Name:___________________________________________ Birthdate:______________ Age:________ Sex:______


Address:____________________________________ City:______________________ State:______ Zip:_________


Telephone:___________________________ e-mail Address: ______________________________________________________


Emergency Contact:__________________________________  Emergency Phone Number:_________________________


Race Entered:   ____12K Race        ____4K Adult Race       ____4K Junior (Place and "X" in the proper blank)


____ Skate Skiing         ____Classical Skiing



12K Race – $20.00   |   4K Adult Fun Race – $10.00   |   4K Junior Race – $10.00 


# of Races Completed_______ Bib #_________ Amount Enclosed: ________________________

Please read this form carefully and be aware that in signing up and participating in this program you will be waiving and releasing all claims for injuries you and/or your child might sustain arising form this program. I know that Nordic skiing is an action sport carrying significant environmental conditions and risks which independently or in combinationwith my activities may cause property damage, severe or evn fatal injuries to me or others.
   As a participant and/or a parent gurdian in the program, I recognize and acknowledge that there are certain risks of physical injury and I agree to assume the full risk of any injuries, including death, damages or loss which I may sustain as a result of participating in any and all activities connected with or associated with such programs. I agree to waive and relinquish all claims I may have as a result of participating in the program against the Joliet Park District, Joliet Nordic Ski Club and its officers, agents, servents, and employees. I do hereby fully release and discharge the Joliet Park District and the Joliet Nordic Ski Club and its officers, agents, servants, and employees from any and all claims from injuries, including death, damage or loss which I may have or which may accrue to me on account of my participation in the program. I further agree to indemnify and hold harmless and defend the Joliet Park District, the Joliet Nordic Ski Club and its officers, agents, servants, and employees from any and all claims resulting from injuries, including death, damages, and losses sustained by me and arising out of, concerned with, or in any way associated with the activities of the program. 

I HAVE READ AND FULLY UNDERSTAND THE ABOVE PROGRAM DETAILS AND WAIVER AND RELEASE ALL CLAIMS.


__________________________________________________________________      ________________________________
  Participant Signature                                                                                                        Date


________________________________________________________________
  Parent/Guardian Signature (if under 18 years of age)

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The Joliet Nordic Ski Club is a Not-For-Profit organization that promotes crosscountry skiing in the Joliet area. Proceeds from this race will be used to defray costs expended on snow grooming equipment. All trails are groomed at no charge to skiers by the Joliet Nordic Ski Club. Serving the Joliet area since 1989.
JOLIET NORDIC
12K & 4K CROSS COUNTRY SKI RACE
APPLICATION FORM
​TBD, 2019 — 9:30 a.m