Father’s Day Walk with Dad
Fun Family Event at Lake Acotink Park
www.MetroRunWalkSpringfield.com
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Date & Time: Sunday June 20th at 8:00 a.m. starting at the Small Shelter (in the Marina) at Lake Accotink Park.
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Description: Join us on Father’s Day as we walk with Dad around Lake Accotink Park. The 493 acres includes a 55-acre lake, wetlands and streams. The trail around Lake Accotink is 3.7 miles in length and can accommodate walkers, runners, jog strollers, and dogs on leashes.
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Bagels, fruit, water, juice, and free giveaways will be available at the Small Shelter. Approximately halfway around the trail, there will be water available.
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Registration: $20 per adult. Children are free.
· Print this page and mail the bottom section of this form
· In person at Metro Run & Walk during store business hours (through June 19)
· Father’s Day June 20 at the Small Shelter at Lake Accotink Park after 7:00 a.m.
· No refunds.
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Beneficiaries: All proceeds donated in support of local recreation and fitness programs for youth in need.
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Awards: This is a family event and is not scored. For those wishing to track their time, we will have our race clock running.
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Questions? Email us at MetroRunWalk.Helen@gmail.com
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Name: _____________________________________________ Gender? M F Event Day Age: ______
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Address: ________________________________________________________________________________________
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Contact Phone: ________________ Alt phone: ________________ Email address: ____________________________
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Would you like to receive Metro Run & Walk’s monthly email newsletter? Y N
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Checks to: Metro Run & Walk CC payment: Visa/MC/Disc # _____________________________
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Exp Date _____/_____ CVV code: ________ Billing address zip code: _____________
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USMail: Walk with Dad c/o Metro Run & Walk, 7261 Commerce St, Springfield, VA 22150.
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Mandatory Liability Waiver: I know that participating in and volunteering for athletic events is potentially hazardous, which could cause injury or death. I will not enter
and participate unless I am medically able and properly trained, and by my signature, I certify that I am medically able to perform this event, and am in good health, and
I am properly trained. I agree to abide by any decision of an event official relative to any aspect of my participation in this event, including the right of any official to
deny or suspend my participation for any reason whatsoever. I assume all risks associated with this event, including but no 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. I understand that
bicycles, skateboards, roller skates, and roller blades are not allowed in these events and I will abide by the guidelines. Having read this waiver and knowing these facts
and in consideration of my participation, I, for myself and anyone entitled to act on my behalf, waive and release Runner Runner Enterprises (dba name Metro Run &
Walk – Springfield), any and all sponsors and affiliated organizations, their representatives and successors from all claims or 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.
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I grant permission to all of the foregoing to use my photographs, motion pictures, recordings or any other record of this event for any legitimate purpose.
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The use of personal music devices is discouraged. Participant enjoyment, responsiveness to instructions, event camaraderie, and individual safety are improved when
are headphone-free.
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The use of baby strollers and baby joggers is restricted to noncompetitive participants who must start at the rear of the race group. I will take extra care to ensure my
stroller/jogger does not interfere with other participants.
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The presence of any animal is restricted to noncompetitive participants who must start at the rear of the race group. All animals shall be leashed, and any animal I bring
will have the social temperament and training to pose no risk to other participants. I will take extra care to ensure my animal does not interfere with other participants.
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Signature (parent or guardian if under 18) Date
