Run For Their Lives 2015
Registration Form
Please send completed form to:
PAWS Chicago Development Office
ATTN: Meg LoBianco
Run For Their Lives
1933 N. Marcey Ave
Chicago, IL 606014
*Registration process will take 1-2 weeks to complete!
1. Name:__________________________________________________________________________________________________
2. Email:___________________________________________________________________________________________________
3. Preferred Username*:__________________________________________________________________________________
4. Preferred Password*:__________________________________________________________
(*to be used for your online fundraising page log-in)
5. Address:________________________________________________________________________
6. City/State/Zip:_________________________________________________________________
7. Phone #:_______________________________________________________________________
8. Registration Type (check one):
Automatic VIP Fundraiser ($125)
Standard ($45)
Child ($15)
9. Payment Information:
Check Enclosed
Credit Card
Credit Card Number:____________________________________
Amount $ :______________________________
Signature:___________________________________________
Date: ____________________________________
REGISTRATION QUESTIONS
1. How did you hear about Run for Their Lives (circle one):
 Facebook
 Email
 Postcard
 Adoption Center
 Friend Referral
 Brochure in a race goody bag
 Returning Participant
 PAWS Chicago Website
2. Who will you be dedicating your miles to this year (circle one):
 Homeless Cats/Kittens in PAWS Chicago’s ‘Kitty City’ Adoption Wing
 Homeless Dogs/Puppies in PAWS Chicago’s Dog Town Adoption Wing
3. Are you a volunteer, foster parent, and/or adopter (circle all that apply):
 Volunteer
 Foster Parent
 Adopter
6. Will you be participating in the 4K Walk (pet-friendly) or 8K Run (humans only, please) (circle one):
 4K Walk (pets allowed)
 8K Chip Timed Run (no pets allowed)
7. If yes, how many pets will you be bringing? Enter 0 for no pets.
____________________________________________________________________________________________________________
8. Participant T-Shirt Size: (unisex sizes in a soft cotton tee) (circle one):
 Youth Small
 Youth Medium
 Adult Small
 Adult Medium
 Adult Large
 Adult Extra Large
 Adult 2XL
 Adult 3XL
9. What will your age be on June 14, 2015?
____________________________________________________________________________________________________________
2015 Event Waiver:
I understand that participating in PAWS Chicago's Run for Their Lives includes an element of risk for both me and my dog. I understand that dogs are not
invited to participate in the 8K Run, that dogs are not permitted to run during the 4K Walk, and that there may be only one dog per registrant for the 4K
Walk. Neither I nor my dog should participate unless the dog and I are physically able and properly conditioned. I agree to abide by any decision of an
event official relevant to the dog's and/or my participation in the event and I further agree that event officials may authorize necessary emergency
treatment for me and/or my dog. I also understand that vehicles, spectators and other traffic may be present along the course and I assume the risk of
participating under such conditions and any others that may arise. I further assume any and all risks associated with participating in this event, including,
but not limited to, injury, illness, falls, contact with spectators, other participants or dogs, effects of the weather including temperature extremes, and the
surface conditions of the event path, all such risks being understood by me. I also affirm that any dog participating with me has current vaccinations. I
agree to abide by all rules of the event.
Having read this waiver and knowing these facts, and in consideration of this acceptance of my entry, I hereby for myself, my heirs, executors,
administrators or anyone else who might claim on my behalf, covenant not to sue, and waive, release and discharge PAWS Chicago, Martin & Karcazes
Ltd., The City of Chicago, Chicago Park District, event officials, volunteers, and any other sponsors, suppliers, agents, employees or other personnel in any
way assisting or connected with this event from any and all claims or liability of any kind whatsoever arising out of my participation in this event, even
though the liability may arise out of negligence or carelessness on the part of the persons or parties named in this waiver.
By registering for the 15th Annual Run for Their Lives I authorize PAWS Chicago to add my address and email to their distribution list. I understand that
my personal information will not be shared with any third parties, and that I may choose to unsubscribe from PAWS Chicago's communications at any
time.
I further understand that by participating in this event, I agree that PAWS Chicago or any sponsors may use my name or pictures of me and/or my pet for
publicity or promotional purposes without any liability or
obligation to me.
I agree to the above terms
Participant Name: ______________________________________________________________________________________________________
Participant Signature: _________________________________________________________________
Date: _________________