A 5K, 10K and Keiki Run Event Saturday May 16th 2015 6:30am This scenic course is set around Green Lake in Kapoho, Hawaii. Spring fed, Green Lake is one of the two natural, fresh water lakes in Hawaii, and is surrounded by a lush and beautiful rainforest. Come run the path around and near a lake that is more than 400 years old. To find out more about this run and access links for online registration please visit: haasindigital.org/livesite/funrun Last Name First Name Address City Phone Gender State Birthdate (MM/DD/YYYY) Age on Race Day Please indicate one of the following: Registration Fees: (online reg. fees apply) Ο HAAS Student/Faculty/Staff Pre-registration: ___$5 Student ___$10 Adult Ο Community Member Zipcode T-Shirt Order ($20 pre-order) At the Door: Ο Small Ο Medium Ο Large Ο X-Large Ο XX—Large Mail registration and payment to: PO Box 1494, Pahoa HI 96778 , or register online at tinyurl.com/haasomerun ___$10 Student __$15 Adult Entry Fee is non-refundable. Bandits will be banned from all future events. Acknowledgement of risk of injury/release and waiver: By signing where indicated below, I acknowledge and understand that there may be risk of injury involved in the activities I may participate in during the 5K walk/run. I know that running and walking a trail race is a potentially hazardous activity. I should not enter unless I am medically able and properly trained. I assume all risks associate with my voluntary participation in this event, including but not limited to, death, falls, contact with other participants, the effects of the weather including extreme temperatures, traffic and all conditions of the road, all such risk being known and appreciated by me. Knowing these facts, and in consideration of your accepting my entry, I for myself, my heirs, executors, administrators, or anyone else who might claim on my behalf, covenant not to sue and waive, release and discharge trends. I hereby agree to release, waiver, discharge covenant not to sue, hold harmless, and indemnify Hawaii Academy of Arts and Science and the Hawaii State educational system, Green Lake, and their respective agents, employees, officers, directors, coordinators, faculty, race officials, workers or volunteers, their representatives, successors or assigns and other staff personnel, and each of their personal representatives, assigns, heirs and next of kin, from any loss, liability, damage or cost resulting from any and all injuries, claims, demand, actions or judgments, which my heirs, executors or administrators may have or claim to have against Hawaii Academy of Arts and Science and the Hawaii State educational system, Green Lake their respective successors or assigns, for all injuries, known or unknown or injuries to property, real or personal, known or unknown, caused by arising out of or related to my participation in the HAASome Run event. Code of Conduct: We expect everyone participating in the event to behave in a mature and responsible way and to respect the rights and dignity of others. Our code of conduct does not permit language or actions that can hurt or frighten another person or that falls below a generally accepted standard of conduct provided in the HAAS student handbook. Suspicion or termination of participation in activities may result from any violation of the Code of Conduct. Signature (Parent or guardian if participant is under 18) Date (MM/DD/YYYY) Email address