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5K/1KPork Chop Trot
Saturday, July 11,, 201
15
P or k Chop Trot
Marty (Pearl Lake), MN
8:00 am – Registration
9:00 am – 5K Run/Walk
10:00 am – 1K Kids Run
Registration Form
Each participant must fill out a separate registration form. No refunds or number transfers.
More race information can be found at www.holycrossmn.org
Course surfaces include grass, dirt, and asphalt and crushed granite.
Name: __
___________________________________ Age on July 11, 201
15:: ______ Gender:
M
F
Address: _________________________________________________________________
_____________
City: ____________________ State: _______ Zip: ________ Phone: _______________
___
___________
E-mail: ___________________________________________________________________
_____________
Type of registration (circle):
5K T-shirt size (circle):
5K Run/Walk
Adult – Small
Med
1K Kids Run (medal only, no t-shirt)
Large
XL
XXL
T-shirts guaranteed to all participants registered by June 19th,, 20
015.. T--shirts to late entrants or day of race entrants while supplies last.
Checks Payable to: Holy Cross School
Mail to:
5K Run/Walk
1K Kids Run
Before June 19th $18.00
Pork Chop Trot
After June 19th
10672 Co. Rd. 8
Kimball, MN 55353
Before June 19th
$25.00
After June 19th
$8.00
$15.00
Waiver Statement
As an entrant in the 2015 Pork Chop Trot, I assume complete responsibility for any injury to me or damage to my property which may occur during the event, or
otherwise. I assume all risks associated with, but not limited to: falls, contact with other par cipants, the affects of the weather, traffic, temperature and course
condi on. I agree not to hold any representa ve of Pork Chop Trot or any organiza on associated, responsible for said injuries. I also grant permission to Pork
Chop Trot and other associated organiza ons to use my name and any photographs, videotapes, mo on pictures, recordings or any other record on me
par cipa ng in this event for any publicity and/or promo onal purposes without obliga on or liability to me. I understan d that the fees are not refundable.
_________________________________________________
Signature
_______________________________________
Date
Land O’ Lakes
Oil & Propane
Thomas Ehlinger
Kimball, MN
A M MAUS AND SON
Millcreek Dairy
Lakeview
Storage
David Stang