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Girls on the Run Mid Michigan 5K Run/Walk
Sunday, May 17, 2015
Charity Run – Benefiting the GOTR Scholarship Fund
Where: Michigan State University
888 Conrad Rd, East Lansing, MI 48824
Time: 2:00 p.m.
Early Registration
Entry Fees:
Registration
Postmarked
by 5/13/15
$30
Postmarked by 5/1/15*
Adult
$25
Child (12 and under) $15
Family
$50
*
Race Day
Registration
$35
$20
$25
$55
$60
Shirts are only guaranteed with registration by 5/1/15
Packet Pick Up: Friday, May 15 at Playmakers, Okemos, 5-8 p.m. and Saturday, May 16 at Owosso’s Farmers Market,
Water and Exchange Street, Downtown Owosso 8 am - 1 p.m. or race day, Sunday, May 17 starting at 11:00 a.m.
Register online at GOTRMidMichigan.org
Chipped timing sponsored by the Michigan Running Foundation.
Contact: Stephanie McClintock at (989) 723-6329, [email protected] or visit us on the web at
www.gotrmidmichigan.org for questions and information on Running Buddies.
Name:
Gender:
Age:
Phone:
State
Zip
Address:
City
Email
T-Shirt Circle Size: Youth: Small Med Large
Adult: Small Med. Large XL XXL
Waiver: In consideration of accepting this entry form, I hereby for myself, my heirs, executors, and assignees waive and release all rights
and claims for damage I may have against Girls on the Run Mid Michigan, the sponsors of the this event, its agents, representatives,
successors, and volunteers for any injuries or damages suffered by me while traveling to, from, or participating in this event.
Photo Release: I hereby grant permission to GORT Mid Michigan the right to use, reproduce, and/or distribute photographs, films,
videotapes, and sound recordings of me, without compensation or approval rights, for use in materials
created for purposes of promoting the activities of GOTR Mid Michigan.
Race day photos will be available at: www.gotrmidmichigan.org
____________________________________________ Date: __________
Signature of Participant or Parent/Guardian, if Under 18 Years of Age
Make Checks payable to GOTR Mid Michigan
Mail Registration Forms to:
GOTR c/o Stephanie McClintock
6070 N. Seymour Rd., Flushing, MI 48433
RACE FEE:____________
DONATION:___________
TOTAL DUE:___________