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City of Richardson
Corporate Challenge

Division A

Richardson city logo

2018 15K Bike Roster for Blue Cross Blue Shield

The undersigned participants release the City of Richardson, Texas, (it's officers, agents and employees) from any injuries or damages sustained as the result of the participation in Corporate Challenge. By the signature below the undersigned participants acknowledges that the undersigned has read and understands the Corporate Challenge rules and agrees to abide by them.

Captain
Last Name First Name PhoneEmail
Marciszko Michal 5027944886

Competitors wearing chips for timing
  Last Name First Name Chip Gender Status Signature
1 Boeding  Steve Male Employee checkmark Signed Waiver Online
2 Chavez Krysta Female Employee checkmark Signed Waiver Online
3 Chernov  Allan Male Retiree checkmark Signed Waiver Online
4 Jeppson Jaime Female Employee checkmark Signed Waiver Online
5 Jeppson Mike Male Spouse checkmark Signed Waiver Online
6 Marciszko Melissa Female Spouse checkmark Signed Waiver Online
7 Marciszko Michal Male Employee checkmark Signed Waiver Online
8 Penn  Alexis Female Employee checkmark Signed Waiver Online
9 Syed Sameer Male Employee checkmark Signed Waiver Online
10 Welton  Steve Male Retiree checkmark Signed Waiver Online

Participants NOT wearing chips for timing
  Last Name First Name Chip Gender Status Signature
1 Baldwin  Alan   Male Employee checkmark Signed Waiver Online
2 Kelley  Lauri   Female Employee checkmark Signed Waiver Online
3 Salas  Wes   Male Employee checkmark Signed Waiver Online
4 To Andy   Male Employee checkmark Signed Waiver Online
5 Torrez  Cathy   Female Employee checkmark Signed Waiver Online
6 Williams  Joseph   Male Employee checkmark Signed Waiver Online