Registration Form - Mead Education Foundation

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MEAD EDUCATION FOUNDATION MEMORIAL FUN RUN/WALK
APRIL 18, 2015
9:00 A.M.
5K run/walk OR one mile kids race
$15 for youth size shirts, $18 adult sized shirt (if postmarked before April 1st)
April 18, at 8:00-8:45 A.M., at the trailhead by Farwell Elementary
School (13005 N. Crestline St, Spokane WA)
Fastest mile for primary (K-3rd) and fastest mile for Secondary (3rd-6th).
Matthew Hopkins
Memorial
Lizzie Jensen
Memorial
Olivia Chaffin
Memorial
Checks Payable to: Mead Education Foundation, P.O. Box 28172, Spokane, WA 99228
Last Name _______________________________________First Name________________________________
E-mail_____________________________________________________________
Address___________________________________________City_____________________State_____________
Date of Birth______________________________
Age_____________________
Non Refundable Donation Enclosed $_________________________
Shirt Size (Circle One): YS YM
S
M
L
XL
Please read and sign: In consideration of acceptance of this entry and intending to be legally bound, I hereby, for my
heirs, executors, and administrators, waive, release and forever discharge all rights and claims for damages which I may
or which, may hereafter, accrue to me, against race director(s), race volunteers, all sponsors and their officers, agents,
assigns, Farwell Elementary School, Mead School District and the Mead Education Foundation from any liability arising
from illness, injuries or damages I may suffer as a result of my participation in this race. I should not enter unless I am
medically able and properly trained, I also assume any and all risks associated with but not limited to falls, contact with
other participants, the effects of the weather, including high head, snow, ice rain, or freezing temperatures, and the
conditions of the roads, trail and/or traffic. Realizing the danger of using headphones I agree to not use them. This is
NOT a pet friendly race! Entry NOT Valid without signature!
Signature___________________________________Signature_______________________________________Date____________
(By Entrant)
(By Guardian if Under 18)
All Proceeds go towards the Mead Education Foundation and then directly into Mead classrooms