To learn more about the 2015 Austin Haitian Hustle, visit www.haitianhustle.com. Race packet pick-up will take place from 8-8:45
a.m. the day of the race (Saturday, June 27). The 5K will begin at 9:00 a.m. with the kid races immediately following the 5K. All
races will begin at Faith Church in Austin (1800 12th St. SW). Contact Mark Bjorlie at 507.993.9282 with any questions. Dogs (must
be on a leash) and strollers are welcome! One registration form must be completed for each participant. Information to register
online is available at www.haitianhustle.com, or complete this form and mail payment (checks made to Faith Church with Haitian
Hustle in the memo line) to:
Faith Church (Attn: Haitian Hustle) : 1800 12th Street SW : Austin, MN 55912
Thank yo
u to
Church in Faith
Austin,
Minn., fo
rh
sponsori osting and
ng this e
vent.
Registration form for
2015 Austin Haitian Hustle (Saturday, June 27)
I am registering for the: c $5 - Kid races (ages crawler to 10 years)
c
$25 - 5K run/walk
Name
Address
City/State/Zip
Phone
Email
Birth date
Gender (circle one)
Male
Female
Shirt size
Youth
c
S
c
M
c
L
c
XL
Femalec S
c
M
c
L
c
XL
Malec S
c
M
c
L
c
XL
Participation waiver
c
XXL
In consideration of acceptance of the entry, I release for myself and my heirs, Faith Church, its officers and volunteers, the City of Austin and any sponsors and all
officials and volunteers of this race from claims, demands, liabilities, damages or causes of action, of any nature, including claims of death, injury or illness, arising
out of participation in any of the distances of the 2015 Austin Haitian Hustle 5k Fun Run|Walk for Education. I state that I have trained and I am in proper physical
condition to participate in this event. I hereby grant full permission to use my name and any photographs, videotapes or other record of this event for any purpose.
I also understand that bicycles, skateboards, roller skates or blades are NOT ALLOWED in the race and that I will abide by these guidelines.
Participant signature
Co-signature (parent or guardian if participant is under 18)
Date