Name(Required) First Last Address Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Gender(Required) Male Female Date of Birth MM slash DD slash YYYY Age day of the racePhone #(Required)Emergency Contact and Ph. #:Email(Required) T-shirts size (Unisex)(Required)XSSMLXLXXL Event Early FeeThrough Sept 30 Fee for October Fee from Responders11/1-14 Fee at Packet Pickup Fee First Responders 26.2 Marathon $80 $90 $100 $120 $35 2-person Relay (fee for 2) $120 $125 $130 $135 $60 Half Marathon $40 $45 $50 $55 $25 Awards by Age categories(Required) 16 yrs. to 19 yrs. 20 yrs. to 24 yrs. 25 yrs. to 29 yrs. 30 yrs. to 34 yrs. 35 yrs. to 39 yrs. 40 yrs. to 45 yrs. 45 yrs. to 49 yrs. 50 yrs. to 54 yrs. 55 yrs. to 59 yrs. 60 yrs. to 64 yrs. 65 yrs. to 69 yrs. 70 yrs. to 74 yrs. 75 yrs. to 79 yrs. 80+ RACE WAIVER OF LIABILITY AND RELEASE STATEMENTEntry is invalid if not signed. In consideration of being permitted to participate in “The Laredo Marathon” event (hereafter referred to as “The Event”), the undersigned, for himself/herself, his/her personal representatives, heirs, and next of kin, HEREBY AGREES AS FOLLOWS: I UNDERSTAND THE EVENT IS A POTENTIALLY HAZARDOUS ACTIVITY AND I HEREBY ASSUME FULL AND COMPLETE RESPONSIBILITY FOR ANY INJURY OR ACCIDENT WHICH MAY OCCUR DURING MY PARTICIPATION IN THE EVENT OR WHILE ON THE PREMISES OF THE EVENT. I HEREBY RELEASE, WAIVE, DISCHARGE, AND HOLD HARMLESS FROM ALL LIABILITY THE CITY OF LAREDO, ITS OFFICERS, DIRECTORS, MANAGERS, SHAREHOLDERS, EMPLOYEES, AGENTS, SPONSORS, REPRESENTATIVES, VOLUNTEERS, AND AFFILIATES, INCLUDING THE OWNERS AND LESSEES OF THE PREMISES (HEREAFTER REFERRED TO AS THE “RELEASED PARTIES”), AND COVENANT NOT TO SUE THE RELEASED PARTIES FOR ANY AND ALL LOSS OR DAMAGE, AND ANY CLAIM OR DEMANDS THEREFORE ON ACCOUNT OF INJURY TO THE PERSON OR PROPERTY OR RESULTING IN DEATH OF THE UNDERSIGNED, WHETHER OR NOT RESULTING FROM THE NEGLIGENCE, GROSS NEGLIGENCE, OR MISCONDUCT OF ANY PERSON, INCLUDING THE RELEASED PARTIES, WHILE THE UNDERSIGNED IS PARTICIPATING IN, OBSERVING OR ATTENDING THE EVENT. SUCH RELEASE AND HOLD HARMLESS AND COVENANT NOT TO SUE SHALL ALSO INCLUDE ANY LOSS, LIABILITY OR CLAIM I MAY HAVE WHETHER SAME BE CAUSED BY FALLS, CONTACT WITH PARTICIPANTS, CONDITIONS OF THE COURSE OR THE EFFECTS OF WEATHER INCLUDING HEAT, HUMIDITY AND RAIN. The undersigned expressly agrees that the above release and waiver of liability is intended to be as broad and inclusive as is permitted by the laws of the State of Texas, and that if any portion is held to be invalid, it is agreed that the balance shall continue in full legal force and effect. The undersigned releases permission that such photographs and/or video recordings of me may be placed on the Internet, printed, Internet or broadcast information that might accompany the photographs and/or video recordings of me. I waive the right to approve the final product. I agree that all such portraits, pictures, photographs, video and audio recordings, and any reproductions thereof, and all plates, negatives, recording tape and digital files are and shall remain the property of The City of Laredo. Confirmation I have read and executed the attached Release and Waiver of Liability form and agree to the terms contained therein.Signature of Participant(Required)Date MM slash DD slash YYYY Signature of Parent/Guardian if under 18 years of ageDate MM slash DD slash YYYY CAPTCHA