Register for Sam Costa Half-Marathon 2023 - Group: Costa Captain - Marketing

Please complete the registration form below to be considered as a volunteer for this event. You will receive a confirmation email if you are assigned as a volunteer.

Registration Information

Please enter your information into the fields below. Required fields are marked with *.

*First Name:
*Last Name:
*Gender:	Male Female
*Date of Birth:	January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923
Address:
City:
State:	Alabama Alaska Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Postal Code:
*Primary Phone:
*Secondary Phone:
*Email:
*Confirm Email:
*Shirt Size:	Youth Large Extra Small Small Medium Large Extra Large XX Large 3x 4x
*Group Password:

Assignment-specific Questions

1. *Are you a current member of Indy Runners? 

   Yes
   No
   

2. *Are you willing to work more than one job? (i.e. registration and finish line)

   *Please list choices, separated by commas (e.g. This, That, etc.) Please DO NOT register a second time. Multiple assignments can be created with just one entry.

3. Special considerations for work assignment (i.e. need to be indoors, or part of a particular group)?

4. Where have you been assigned previously?

5. *Are you registered to run one of the Sam Costa Races? If so, which?

   Half
   Quarter
   Neither
   

6. *Are you a student at a local school? If so, what school are you representing?

   -- Select an answer -- Not a student Carmel Fishers Hamilton Heights Hamilton Southeastern Noblesville Westfield Other

7. Are you wishing to receive credit for volunteer hours? If so, please specify the organization. We will be happy to sign your paperwork.

Registration Waiver

WAIVER, RELEASE, AND CONSENT I wish to volunteer for the Sam Costa Half Marathon/Quarter Marathon. I understand that the nature of the activities I may perform in my capacity as a volunteer may involve physical activity, contact with unidentified and/or unfamiliar persons, the effects of weather, including but not limited to, heat, humidity, rain and/or lightning, conditions of the road and traffic on the course, including but not limited to, icy and slick roads and sidewalks, automobiles, bicycles and other vehicles, or other potential risk of bodily injury or damage to property. I am medically able to volunteer. I assume all risks associated with volunteering and otherwise participating in the Sam Costa Half/Quarter Marathon. I agree to independently consult with my physician in the event of any injuries or medical questions arising from my volunteering in the Sam Costa Half/Quarter Marathon and I am responsible for my own medical expenses. In consideration of being allowed to volunteer, I waive, release, and hold harmless Indy Runners, Inc. and all of its officers, directors, members, volunteers and sponsors, the Road Runners Club of America, Northview Church, City of Carmel, the City of Noblesville, the County of Hamilton, the State of Indiana, the successors of each organization and the heirs, assigns and personal representatives of each individual and his or her estate, from all claims of any kind for liabilities of any kind arising from my volunteering or otherwise participation in these activities, even though that liability may arise out of negligence or carelessness on the part of persons named in this waiver. I consent and grant my permission to Indy Runners, Inc., to use, without compensation, my image or likeness in print and digital media which promotes the club. I understand and agree that this Waiver, Release, and Consent is binding upon my heirs, assigns, and legal representatives.

* I fully understand and accept all conditions in this waiver.

Please Sign Below

Your electronic signature is the online equivalent of your ink-on-paper signature, and can be provided by typing your name where indicated. The electronic signature will signify your understanding, acceptance, and authorization to accept the conditions of this legal document, including the following statements:

• I have read, have understood, and do accept the agreement above.
• I understand that this is a legal document with effects that I approve and authorize.
• The registrant is the person(s) whose name is submitted as the recipient of the goods and services provided as a result of this transaction.
• I am authorized to agree to the terms of this document on behalf of the registrant.
• If the registrant is under 18 years of age, incapacitated, or mentally challenged, I assert that I am the parent/legal guardian or otherwise authorized to execute a legally binding agreement on behalf of the registrant.

• *Signature:

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You are encouraged to keep a copy of this agreement for your records. This agreement was generated at 4:47:34 AM EDT on 3/21/2023.
Click here to print the agreement.