circle one t-shirt size sml xl xxl the giraffe run

The Giraffe Run is an event to benefit the Power of the Giraffe
Non For Profit. The Power of the Giraffe raises money to help
families that are going through Cancer treatments. It’s mission
is to also inspire others to stick their neck out for their fellow man.
There will be a scenic 5k run along the Mississippi River as well
as a 1 mile fun walk. Join us the morning of Saturday, May 16th
to further our journey to help others to in their fight with Cancer.
DATE
Saturday, May 16, 2015
START TIMES
5K | 9:00am
1 Mile | 9:15am
LOCATION
Alton Riverfront Park
1 Riverfront Drive
Alton, IL 62002
PACKET PICK-UP
Friday, May 15th, from 3-5pm at Our Lady Queen of Peace School (132 Butcher St., Bethalto, IL 62010)
Mail form to: FLEET FEET RACE PRODUCTIONS, 3813 Mexico Road, St. Charles, MO 63303. Checks made payable to “FLEET FEET Sports”.
THE GIRAFFE RUN
RACE
check one
5K
1 MILE
$25 per participant
$25 per participant
FIRST NAMELAST NAME
ADDRESS
DATE OF BIRTH
CITY
MALE/FEMALE
PHONE NUMBEREMAIL
I have read, understand and agree to the terms of the waiver below.
PARTICIPANT'S SIGNATURE
*Parent or guardian required to sign if applicant is under 18 years of age.
STATE/ZIP
CIRCLE ONE
T-SHIRT SIZE
S
M
L
XL
XXL
Shirts guaranteed for
participants who register by 4/25
DATE
LEGAL
You must read and agree to the following waiver in order to participate in this event. By signing below, I the undersigned (if applicant/participant is 18 years of age or older) or
parent/guardian of the above listed minor applicant/participant acknowledge that running a race is potentially hazardous activity, which could cause injury or death. I will not
enter and participate unless I am medically able and properly trained, and by my signature, I certify that I am medically able to perform this event, and am in good health, and I am
properly trained. I agree to abide by any decision of a race official relative to any aspect of my participation in this event, including the right of any official to deny or suspend my
participation for any reason whatsoever. I attest that I have read the rules of the race and agree to abide by them. I assume all risks associated with running in this event, including
but not limited to: falls, contact with other participants, the effects of the weather, including high heat and/or humidity, traffic and the conditions of the road/course all such risks
being known and appreciated by me. I understand that bicycles, skateboards, roller skates or roller blades, and animals, are not allowed in the race and I will abide by all race
rules. Having read this waiver and knowing these facts and inconsideration of your accepting my entry, I, for myself and anyone entitled to act on my behalf, waive/release and hold
harmless; The Power of the Giraffe NFP, ThePoweroftheGiraffe.org, Power of the Giraffe GIRAFFE RUN 5K Run Staff (it’s directors, officers, coaches, athletic trainers, supervisors, and any
other employees or agents), Fleet Feet Sports, the City of Alton, the Alton Riverfront Park, Alton, IL and any and all event sponsors, their representatives and successors from all claims
or liabilities of any kind arising out of my participation in this event, even though that liability may arise out of negligence or carelessness on the part of the persons named in this
waiver. I grant permission to all of the foregoing to use my photographs, motion pictures, recordings or any other record of this event for any legitimate purpose.