Instructions

Type in your information in the blanks provided. Be sure you've spelled everything correctly. What you type is what we will use for your registration. When you are done, click the print button to the rightuse your browser's print function.


Some older browsers may not print all of the fill-in contents of a web form like this one. If this happens, please use a pen or pencil to fill in the printed form by hand. Please write as clearly as possible.

This form may not print to a single page with some browsers. Try turning off any headers / footers in the print window before printing. If you do get two pages, please do not forget to sign the second page. Registrations without a signature will not be accepted.

If you encounter any other display, printing or technical problems with this form, please email us and let us know.

For event related questions, please visit aasportsltd.com/heartbreaker, or send an email to events@aasportsltd.com.

2017 Heart Breaker Half

Presented by Providence

Sunday, February 12, 2017 -- Liberty High School, Hillsboro, Oregon
For more information, visit aasportsltd.com/heartbreaker, or send an email to events@aasportsltd.com.

Please double check everything before mailing: spelling, birthdate, shirt sizes, etc.  It is very important that we know which event you'll be participating in (highlight or circle the event after printing).  If you use pen or pencil to fill in the form, please write clearly.  Illegible, incorrect, or falsified information could lead to disqualification and removal from results and awards eligibility.

Which event would you like to participate in?

 

Make checks payable to:

Heart Breaker Half

Mail entry to:

AA Sports Ltd / HB
4840 SW Western Ave, #100
Beaverton, OR 97005

WAIVER MUST BE READ, SIGNED AND MAILED WITH ENTRY
I know that participating in an organized athletic event is potentially hazardous, and that I should not enter to participate unless I am medically able and properly trained. I HEREBY ASSUME THE RISKS OF PARTICIPATING IN THIS EVENT. I certify that I am physically fit and that I have sufficiently trained. I agree to abide by the competitive rules. I hereby take the following action for myself, my executors, administrators, heirs, next to kin, successors and assigns, or anyone else who might claim or sue on my behalf, and I hereby waive, release and discharge from any and all claims, losses, or liabilities for death, personal injury, partial or permanent disability, property damage, medical or hospital bills, or theft which may arise out of or relate to my participation in this event. I agree not to sue, and to hold harmless any and all persons, sponsors, volunteers, participants or government agencies for any and all claims or liabilities that I have waived, released or discharges herein. I understand that my email address will be used for other race promotional purposes.I understand that the Entry Fees are Non-Refundable/Non-Transferable.

Signature:

Date:

(Signature of Participant or Parent / Legal Guadian if participant is under the age of 18)

Form provided by AA Sports, Ltd. / 2012