Registration Form - Maquoketa Chamber Of Commerce

5K Color Walk/Run
S a t u r d ay : M ay 3 0 , 2 0 1 5
Pre-Registration- www.getmeregistered.com or
www.maquoketachamber.com
Or: Visit us on Facebook Maquoketa Chamber Events for
pre-registration form & event details!
Registration starts at 3:00 pm @ Timber Lanes
2015
Time: 5:00 pm (NEW START TIME)
Cost: Adults $25;
Ages 18-11 years $15
Children 10 and under free
th
MUST BE REGISTERED BY MONDAY MAY 15 TO RECEIVE
SPRING COLOR FLING BANDANA!!!!
NEW THIS YEAR!!! Route includes nature trail through the
brand new Prairie Creek Recreation Area!
Race starts and ends at Timber Lanes.
(Must be accompanied by an adult)
THE EARLY
GETS THE
!! REGISTER by
May 15th for $5 off your entry fee ($20 instead of $25)!
_______________________________________________________________________________________________________________
Name_____________________________________________________________________________
Address___________________________________________________________________________
City__________________State___________Zip______________Phone___________________
Email__________________________________________________
Age on Race Day_____________Birth Date____________M/F___________
5K Walker___________5K Runner_____________
Child’s Name______________________________________________
** AFTER THE RACE, STICK AROUND
FOR MUSIC, FOOD, AND AN ARRAY
OF OTHER FUN ACTIVITIES!
SPONSORED BY:
TIMBER LANES &
WARTHAN BROTHERS
MAQUOKETA FORD!!
Age on Race Day_______________ Amount Due________
Child’s Name______________________________________________
Age on Race Day_______________ Amount Due_________
Child’s Name______________________________________________
TOTAL AMOUNT DUE: $__________
(Total amount due with registration form)
Age on Race Day_______________Amount Due__________
**Attached is a waiver that must be signed/checked, which confirms you have read and agree to all terms and conditions. This must be
completed at time of application.
For more information or questions: Maquoketa Area Chamber of Commerce- 124 S. Main, Suite 2, Maquoketa, IA 52060
(563) 652-4602 or (800) 989-4602 Fax: (563)652-3020: [email protected], www.maquoketachamber.com: or visit us
on Facebook www.facebook.com/maquoketachamberevents