Please print clearly and
complete a separate form
for EACH participant.
5K RUN
2 MILE WALK
Early Bird: $20
After May 15: $25
Early Bird: $20
After May 15: $25
GIGGLE GALLOP
BUTTERFLY
RELEASE
I am unable to attend, please
accept my tax-deductible
donation of $______.
Children ages 2-8: $10
Name:________________________________________________________________ Age: (day of race)_________ Gender:
M
Reserve one
butterfly: $20
F
Address:_________________________________________________________ City:________________________ State:_______ Zip:___________
Phone: (_____) ____________________ E-mail:____________________________________________________________ Adult Sock Size:
$10 Donation ADULT T-shirt: S
M
(please circle, sizes guaranteed by May 1)
L
XL
Team of 10 or more ~ $18/participant
$10 Donation YOUTH T-shirt: S
M
M
L
m Ovarian Cancer Survivor
L
m Run/Walk in memory/honor of:
Team Name:________________________________________
–––––––––––––––––––––––––––––––
Waiver of liability and release of all claims: As a participant of Laura’s Smile Mile 5K Run/Walk or The Giggle Gallop with Laura’s Smile Foundation, I recognize and acknowledge that there are risks of physical injury to myself and others while participating in the 5K
or children’s run with Laura’s Smile Foundation. I agree to assume the full risk of any and all injuries, including death, and all damages or loss, regardless of severity, which I may sustain as a result of participating in any and all activities connected with or associated
with this 5K or children’s run with Laura’s Smile Foundation. I do hereby waive, release and relinquish all claims, including all claims for bodily injury, death and/or property damage, against Laura’s Smile Foundation and its associated companies, stockholders,
directors, members, managers, agents, athletes and employees as a result of participating in any and all activities connected with or associated with this 5K or children’s run with Laura’s Smile Foundation, including all claims for negligence. I hereby covenant not to
sue and agree to indemnify, defend and hold Laura’s Smile Foundation and its associated companies, stockholders, directors, members, managers, agents, athletes and employees harmless from all claims (including all claims for negligence), liability, and loss arising
out of or incurred in connection with m in connection there with. I acknowledge that I have read and fully understand the foregoing waiver and release.
Signature of Entrant:_______________________________________________ Date:_______________
*Waiver must be signed by participant or Parent/Guardian if under 18 years of age. Unsigned entries will not be honored.
LSF15H
Make checks payable to Laura’s Smile Foundation
Mail to: Laura’s Smile Foundation,
2312 Lake Bluff Blvd., Shorewood, WI 53211
Ova
rian
Canc
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arenes
s
ADDRESS SERVICE REQUESTED
2312 E. Lake Bluff Blvd.
Shorewood, WI 53211
9th Annual Ovarian Cancer Awareness 5K Run/2 mile Walk presented by Laura’s Smile Foundation
June 6, 2015
10:30 a.m.
11:30 a.m. Giggle Gallop
Veterans Park, Milwaukee
10-19
20-29
30-39
40-49
50-59
60+
for Kids!
Goodie bags, racing bibs and
t-shirts will be available in
advance Friday, June 5, 11:30 a.m.
to 7 p.m. at Performance Running
Outfitters, Shorewood.
Dogs, skates,
rollerblades, skateboards
and bikes are prohibited
from the Run/Walk.
Proceeds to benefit WOCA
and Laura’s Smile Foundation.
Laura’s Smile Foundation
2312 Lake Bluff Blvd.
Shorewood, WI 53211
SEND TO
Day of race registration will take
place at Veterans Park, Milwaukee,
from 8:00 a.m. - 10:00 a.m.
DAY OF RACE
MAIL: Use the attached form to register
via mail. Pre-registration must be
received no later than June 1, 2015.
Registration forms to print are available
at www.laurassmilefoundation.com.
REGISTER ONLINE: www.active.com
LAST DAY to pre-register is June 1.
PRE-REGISTER
Make checks payable to
Laura’s Smile Foundation
All Run/Walk participants will receive reusable goodie
bags and running socks. All Giggle Gallop participants
will receive goodie bags and medals. Every registered
participant will be entered into the free raffles.
Run/Walk Early Bird by May 15: $20
Run/Walk after May 15: $25
Giggle Gallop: $10
FEES
Registration
A tax exempt non-profit corporation
Laura’s Smile Foundation
Champion Level - $2500
Teal Level - $1000
Gold Level - $500
Silver Level - $250
Bronze Level - $100
www.laurassmilefoundation.com
Check out our website for more info.
Be a Sponsor.
Make a huge difference!
Advance Packet Pickup
In memory of Laura David
April 22, 1981–July 3, 2011
• Decorate racing bibs
• Face Painting ~ $1 donation
• Bouncy Houses ~ $ 1 donation
• Cupcake Decorating ~ donation
www.laurassmilefoundation.com
With a minimum $20 donation
to Laura’s Smile Foundation,
you can release your very own
butterfly to remember or
honor a loved one.
Reserve by May 15, 2015.
Butterfly Release
Please help us make a difference! Every
dollar increases research and awareness for
ovarian cancer. Gather pledge donations
prior to the event. Track all monetary
donations on pledge sheet. This is
optional. Awards will be given to
the top 3 to say thank you for your
fundraising efforts.
PLEDGES
Given to the top 3 overall male and female 5K winners
and the first 3 males and females in each age category.
Medals given to all Giggle Gallop participants.
AWARDS
9&
Under
AGES
Race will start and finish at Veterans Park
located on Milwaukee’s lakefront at:
1010 North Lincoln Memorial Drive, Milwaukee, WI
The route will start at the pavilion and continue around the
lagoon to the War Memorial and finish at the pavilion.
WHERE
Saturday, June 6, 2015
Run/Walk Start 10:30 a.m.
Giggle Gallop (children ages 2-8) 11:30 a.m.
WHEN
The 3.1 mile (5K) run, 2 mile walk is open to men, women and
children. The Giggle Gallop is about 1/8 mile and is open
to all children ages 2-8. The post race party will include
refreshments, FREE raffle, LIVE entertainment and awards
ceremony held at Veterans Park, Milwaukee. Proceeds will be
given to Laura’s Smile Foundation and the Wisconsin Ovarian
Cancer Alliance to educate and advocate about ovarian cancer.
WHAT
Laura’s Smile Mile