Little Rock Marathon

183 Days to race day

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Northeast Arkanas Training Meeting - August 26 @ 6 pm

Little Rock Marathon Training Program Begins - Info Meeting Aug 9

LOOKING FOR LEADERS

Training Registration Form

Items with an asterisk(*) are required.

PERSONAL INFORMATION
First Name:*
Last Name:*
Date of Birth:*
Address:*
City/State:*
Zip:*
Cell Phone:
Other Preferred Phone:
Email Address:*
I wish to train with the group in:	Specify, if other:

FITNESS INFORMATION

How did you hear about the training program?*

I would consider myself a (select one):* Newbie (never done anything like this before)
Runner/Walker (been doing it for a while and need some new goals)
Serious Runner (verrrry serious about my training and need to socialize with other serious runners)

What brand of shoes do you train in?*

How old are your shoes?* (if you mow the lawn in them you probably need to get another pair of shoes before you begin training)

What is your pace?* (how long does it take you to go a mile - i.e. 8 min mile)

How often do you currently run/walk each week?*

How many miles do you run/walk each week?*

What was your longest run/walk in the last 3 weeks?*

What surface do you normally train on?*

Are you training to (select one)*:

What is your goal in this program?*

Do you lift weights or cross train?* Yes No
If yes, how often?

Do you have any health problems we should be aware of?*

Are you taking any medications that we should be aware of?*

Have you had any sports related injuries in the past year?*

We strongly suggest consulting your physician before participating in any program of the Little Rock Marathon.

EMERGENCY CONTACT INFORMATION:

Emergency contact name*

Relationship*

Phone*

LITTLE ROCK MARATHON TRAINING PROGRAM RELEASE:

Please read the statement below and check the box to indicate your agreement with all of these terms.

I understand and agree that there are inherent risks, both foreseeable and unpredictable, associated with any exercise program. I agree to assume and accept full responsibility in spite of and with full knowledge of these risks. My participation in this program is purely voluntary. I hereby fully agree and hold harmless the Little Rock Marathon, any sponsoring organization, marathon officers, directors, employees, agents, members, or volunteers, together with their insurers, of and from any and all liability, claims, damages or causes of action for any reason, including, without limiting the generality of the following, death, bodily injury, property damage or any other loss or inconvenience whatsoever, suffered by me at any time hereafter occurring as a result of my voluntary participation in the Little Rock Marathon Training Program. I do hereby, for myself, my heirs, executors and administrators, fully waive, release and forever discharge any and all rights and claims for damages that I may have or that may hereafter accrue to me arising out of or in any way connected with my participation in this or any future programs. I also represent and warrant that I have been advised to consult my doctor about whether I can safely participate in this program and whether there are precautions or limitations to my participation. I hereby consent to interview, press interview, photographs, films, television and radio for the purpose of public and private release, showing or reproduction. I agree and acknowledge that I have read this agreement and understand its terms and conditions; and, that if any portion of it is held invalid, the balance shall continue in full force and effect.

I agree to the waiver and conditions