(print this page and mail it with your registration fee to:
John Trigg Ester Library, attn: Library Sextathlon, PO Box 468, Ester, AK 99725)
or scan your signed form and e-mail separately to library@esterrepublic.com

Registration forms must be postmarked by February 22, 2010.

Event description & rules here.

Registration fee: $20 per team

Participant Information

Team Name:

Members (up to 4 people):

1.

 

2.

 

3.

 

4.

 

Institution Represented:

Address:

Phone:

E-mail:

Website and/or blog:

NOTE: Risk waiver must be signed before entry can be processed.

Parent/guardian must sign for entrants under 18

By signing below, I accept and agree to the following conditions:

Events in the Library Sextathlon are action and flexibility sports with hazards and risks which can cause me severe injury or death. In consideration for my participation in this event, I understand and accept the responsibility for these risks, conditions, and hazards. I hereby release and waive any claim I may have against the organization and people conducting and/or hosting this event--the John Trigg Ester Library, the Annex art space and gallery, and the Friends of the John Trigg Ester Library--for any injury, including death, which may come to myself (or my child) as a result in this event, including as a result of negligence of any person or entity.

Participant 1 Signature:________________________________________

Date:___________________

Participant 2 Signature:________________________________________

Date:___________________

Participant 3 Signature:________________________________________

Date:___________________

Participant 4 Signature:________________________________________

Date:___________________

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