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Scholarship Form

"*" indicates required fields

Child's Name*
Date of Birth*
Gender*
Distance*
Child's Training Location*
Choose the location that works best for you!
Child's T-Shirt Size*
Keep in mind that athletic shoes typically run .5 size smaller.
Have you received a scholarship previously for your child to attend?*
Address*

PARTICIPANT'S ADDITIONAL MEDICAL INFORMATION

Waiver*
I know that participating in the GO FAR program, GO FAR 5K and Fun Run is a potentially hazardous activity. I should not enter and participate unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I assume all risks associated with participating in GO FAR activities including, but not limited to falls, contact with other participants, the effects of the weather, including high heat and/or humidity, traffic and the conditions of the road, all such risks being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of your accepting my application, I, for myself and anyone entitled to act in my behalf, waive and release any and all sponsors including but not limited to, Dare County Schools, the GO FAR Inc., OBX GO FAR program, GO FAR coaches, race officials, volunteers, all municipal agencies whose property and/or personnel are used and all other sponsoring or co-sponsoring companies or individuals, their representatives and successors related to the OBX GO FAR from all claims of liabilities of any kind arising out of my participation in this event, even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I hereby release, indemnify, and hold harmless GO FAR, its officers and directors, employees, agents, program coordinators, volunteers, promoters, sponsors, any municipalities or other public entities, from and against any and all claims arising from the training program and the subsequent 5K road race. I grant permission to all of the foregoing to use any photographs, motion pictures, recordings or any other record of this event for any legitimate purpose. NOTE: IF PARTICIPANT IS UNDER AGE 18: this is to certify that my son/daughter has my permission to participate in the GO FAR program and OBX GO FAR race, is in good physical condition and that race officials have my permission to authorize emergency treatment if necessary.
This field is for validation purposes and should be left unchanged.

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