Middle School Individual Entry Form 

Return one form for each child and $5 payable to Colts Neck Cross Country.

Send to Colts Neck High School, C/O Jim Schlentz, 59 Five Points Road,

Colts Neck, NJ, 07722.  Entries close on Friday, September 19th, 2008.

Name of Child:  ________________________________________________

Name of Parent/Guardian:  ________________________________________

Address:  _____________________________________________________ 

City: _________________________   State:  ________   Zip: ____________

Phone Number:  ________________________________________________

School: ______________________________________________________

Allergies or Current Medications:  ___________________________________

Athlete’s Release:  In consideration of your acceptance on my entry into the Cougar Invitational at Bucks Mill Park on September 27^th, I voluntarily agree to participate in the 2008 Cougar Invitational and knowingly assume any and all risk of loss, damage, property loss, injury (including death), both foreseen and unforeseen, of my attendance at and participation in the Cougar Invitational, from any cause whatsoever.  I, for myself, my heirs, personal representatives and assigns do hereby release, waive, discharge and covenant not to sue Colts Neck High School, Colt Neck Township, the organizers of the Cougar Invitational from all liability, loss, claims, demands, possible causes of action, court costs, settlement costs and fees, attorney fees and any other expenses arising from any claim or lawsuit that may arise in connection with the Cougar Invitational.  I/We grant permission to the Meet Directors or their designee or the assigned Chaperones to act as guardian/spokesman with full authorization and power to authorize emergency medical treatment, including hospitalization, if medically necessary. 

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(Signature of Child)                                      (Signature of Parent)

Parent Cell Phone Number:  ______________________________________

Emergency Contact Name and Phone Number:  _______________________