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It’s just a Hill, Get Over it...
Oh Mother…
Registration
NAME
Friday May 8
ADDRESS
CITY STATE ZIP
PHONE
EMAIL
AGE ON RACE DAY
Race Details
/
/
M
or F
CIRCLE CHOICES:
• RUN/FEES
On Line or by mail by 5PM May 7
HALF $50
10K & 5K $35
On site May 8 & 9:
HALF $60
10K & 5K $45
Kids Fun Run ¾ mile (no age limit) $5
Includes finisher medal and a cotton shirt.
5K, 10K & HALF Include Tech T’s
Finisher medals for all HALF finishers!
All events - T-Shirt guaranteed only if
registration is received by April 18.
• SHIRT SIZE Male Female (circle type)
Adult - S M L XL XXL
Unisex Youth - S M L
Make checks payable to;
Optimist Club Lodi
Mail to
LOMOAR c/o Spring Creek Engineering
218 S. Main St.
Lodi, WI 53555
Run Info call: 608-592-1077
Packet Pickup
5-7pm
Spring Creek Office Center
113 S. Main St.
Half Marathon,
10K, 5K, Mile
Saturday May 9
Run/Walk
&
Youth Fun Run
Start Times:
On Site registration opens
Half Marathon
10K
5K
KIDS FUN RUN
6:30 am
8:00 am
9:00 am
9:15 am
9:30 am
Course maps are posted on-line.
Awards to top 3 M&F overall winners and 1st
place age group winners
$100 Runners Gift Certificates for the male and
female overall winner of the 5K, 10K & HALF
Host Hotel
Lodi Valley Suites
N1440 Hwy 113
Lodi, WI
608-592-7331
www.lodivalleysuites.com
Saturday
May 9, 2015
Lodi, WI
Call for room rates – Mention One Mother of a Run
“Like” us on Facebook
Contact us at:
[email protected]
www.onemotherofarun.com
A challenging course on quiet country
roads including WI Rustic Road 110
Release of Liability
In consideration of being allowed to participate in
any way in the event and all related activities,
About Lodi Optimist
The Optimist Club of Lodi is our event title
sponsor and provides support through funding,
accounting and event insurance.
Optimist International is an association of
more than 2,900 Optimist Clubs around the
world dedicated to “Bringing out the Best in
Kids.” Adult volunteers join Optimist Clubs to
conduct positive service projects in their
communities aimed at providing a helping
hand to youth. With their upbeat attitude, the
Optimist Club empowers young people to be
the best that they can be.
Each Optimist Club determines the needs of
the young people in its community and
conducts programs to meet those needs.
About Activate Lodi
Activate Lodi is a group of community
members and businesses whose goal is to
provide education and activities for all ages and
ability levels.
We want everyone to understand what health
and wellness is all about. To this end we hope
to make our community in the Scenic Lodi
Valley one of the healthiest communities in the
Nation!
We do this by providing public education
events like our annual Health & Wellness
Expo. We also coordinate the annual Duck-AThon Triathlon, Duckling Triathlon, Winter
Festival and One Mother of a Run.
Get involved! Contact us via the Activate Lodi
Facebook Page for volunteer opportunities.
I __________________________, the undersigned, parent
or legal guardian, acknowledges, appreciates, and
agrees that: The risk of injury from the activities
involved in this event exists. While particular rules,
equipment, and personal discipline may reduce this
risk, the risk of serious injury does exist. I
knowingly and freely assume all such risks, both
known and unknown, and assume full
responsibility for my participation. I, for myself and
on behalf of my heirs, assigns, personal
representatives and next of kin, hereby release,
indemnify, and hold harmless the event, all
volunteers, organizers, professional support,
Activate Lodi, the City of Lodi, Lodi School District
and the Optimist Club of Lodi, with respect to any
and all injury, disability, death or loss or damage to
person or property, to the fullest extent permitted
by law.
I also agree to release all images, comments,
likeness, etc. of or made by me regarding this event
for use by the above named parties.
I have read this release of liability and assumption of
risk agreement, fully understand the terms
understand that I have given up substantial rights
by signing it and sign it freely and voluntarily
without any inducement.
Parent Signature of Participating Minor
Date
As participant, I willingly agree to comply with the
stated and customary terms and conditions for
participation.
Signature of Participant
Date