6th Annual Ka`a`awa Elementary School 5K Family Fun Run/Walk Kualoa Ranch- Ka`a`awa Valley * Surf Spot Entrance * Bring your camera for awesome views! Saturday, April 25, 2015 8:00 - 10:00 a.m. Check in 7:00 a.m. Watch for road signs on directions! 1. Complete legibly and completely. Everyone on the course must be registered. Additional forms are available at Ka`a`awa Elementary School or our website at www.kaaawa.k12.hi.us. If you have any questions, call 237-7757 or email [email protected]. You may also register online at http://active.com/. All applications received in the office by Friday, March 20, 2015 to receive a free Ka`a`awa 5K Fun Run T-Shirt. All applicants will receive a free bottle of water. Check-in station will use the first name on the application form if more than one applicant is registering. If you need additional space, use another application and attach. All participants must leave property by 10:30 a.m. or cars will be locked in. First Name:_________________________________ Last Name: ______________________________ M.I. _____ M or F______ Age: _______ First Name:_________________________________ Last Name: ______________________________ M.I. _____ M or F______ Age: _______ First Name:_________________________________ Last Name: ______________________________ M.I. _____ M or F______ Age: _______ Address :__________________________________________________________ Apt No. ______ City: ________________ State: ____________ Please check T-Shirt Size below: Youth Sizes: Youth Small ___ Youth Medium ___ Youth Large ___ Adult Sizes: Small ___ Medium ___ Large ___ XL ___ XXL ___ Best Contact Number Including Area Code: ___________________________________________________________________________________ Emergency Contact on Day of Event Including Area Code: ______________________________________________________________________ Email Address: ___________________________________________________ 2. Check box below. 2015 Ocean Warrior Family Fun Run Please drop off or mail to at Ka`a`awa El. Before March 20 Adults $20 Students (Under 18yr.) $ 10.00 After March 20 Adults $25 Students (Under 18yr.) $15 Total Enclosed: $_________ Due date for free shirt is Friday, March 20, 2015. Make non-refundable entry fee check or money order payable to: Ka`a`awa Elementary School C/O Alakai Manu 51-296 Kam Hwy. Ka`a`awa, Hawaii 96730 $25.00 assessed for returned checks All children must be accompanied by an adult 3. Please Read and Sign Please Read and Sign (Sorry we cannot process without your signature) I, _______________________, the undersigned, on behalf of myself and/or underage child, wish to enter the Ocean Warrior 5K Family Fun Run to be held at Kualoa Ranch. I understand that participating in a running race on undeveloped roads and trails through Kualoa Ranch is a potentially hazardous activity, that accidents and /or injuries can occur. I hereby take full responsibility for myself and my family and agree to hold Kualoa Ranch Hawaii Inc., Ka`a`awa Elementary School, and all the people responsible for putting on this race harmless from any and all claims due to accidents, injury or other loss that may arise our of my/our participation in this race. I also understand and accept that if this race cannot be held due to severe weather or other unforeseen circumstances, Ka`a`awa Elementary School is not liable to refund any entry fees or other monies. _____________________________________ Date: ________ Name of person(s) being entered Pet friendly event. Leash and clean up required. Mahalo. ________________________________________________________________ Signature of participant or parent of the participant
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