Medoc Meltdown 50k
Medoc Mountain State Park
August 20, 2011
Starting at 7:30am (Park Opens at 7am for our group)
For more information contact:
Frank Lilley 252-586-4307 after 6 pm
Cam Kelly 919-332-2052
Waiver and Release
I realize August in eastern North Carolina is damn hot and humid. Most people and trained medical doctors would strongly advise against running even a short distance in high heat and humidity.
I realize this is not a race. This is simply a fun run which I choose to do in spite of all the dangers involved. These include (but are definite not limited to): heat, humidity, logs, rocks, poison ivy, snakes and perhaps even a bear or two and who knows what other potentially dangerous and even life-threatening risks.
Therefore, I want everyone to know that I agree for myself and for all my survivors or possible claimants that I may leave behind, to save, release and hold harmless Frank Lilley, Cameron Kelly, Medoc Mountain State Park, the State of North Carolina and any volunteers from all liability, claims or demands for damages incurred by participation in this event or any of its parts. I assume all responsibility for my participation and certify I am properly trained, mentally fit and medically able to participate in this extremely difficult and dangerous fun run. I understand there are no official aid stations; there will be no medical professionals in attendance. I will totally support myself.
Signature _____________________________________
Date _______________
Parent or Guardian if under 18 _____________________________________
Name (print) _______________________________________________________
Address ________________________________________________________
City / State / Zip _____________________________________________________
E-mail address: ____________________________________________________
Emergency Contact
Name __________________________________________
Phone # ________________________________________
PLEASE FILL THIS OUT AND BRING IT WITH YOU TO THE FUN RUN.