2015 REARDAN MULE DAYS FUN RUN OFFICIAL ENTRY FORM REGISTRATION: Only submit one form per participant. FEES: Registration is $8 (no shirt), $16 for the run and includes a 2015 t-shirt. Entries must be postmarked by May 21, 2015 and are nonrefundable. Late entries (After May 21, 2015) add $4.00 and packets will be held at the “Late Registration Table”. If you do not want a t-shirt and simply enjoy running the entry fee is $8 until May 21, 2015. Fees are nonrefundable. (Check fee schedule on next page.) No shirts with late entries! START/CHECK IN/FINISH LINE: Start and check-in is at Joe B. Johnson Athletic Field. Packets and shirts may be picked up and check-in is Saturday June 6, 2015 from 6:30-7:45 am. Instructions will be at 7:45; race starts promptly at 8:00. The run will take place rain or shine. FACILITIES: Water stations for 5K at turnaround, 10K at 2 and 4 miles. Juice for all participants at finish. Restrooms/Showers available. (Bring your own soap and towel.) PRIZES: All full entry participants receive a custom designed t-shirt for the 2015 Reardan Mules Days Fun Run. First and Second place in both 5K & 10K runs receive a plaque. Awards presented at finish line at approximately 9:15 a.m. at finish line. Last Name: _________________________ First Name: ________________________________ Phone Number: _____________________ E-mail Address: _____________________________ Address: ______________________________________________________________________ City: ______________________________ State: _______ Zip Code: ______________________ FEES ⃝ $16.00 Run & Mule Chase T-Shirt DIVISION T-SHIRT SIZE ⃝ MALE ⃝ 5 KILOMETER ⃝ A 8 – 13 ⃝ SMALL ⃝ FEMALE ⃝ 10 KILOMETER ⃝ B 14 – 20 ⃝ MEDIUM ⃝ C 21 – 39 ⃝ LARGE ⃝ D 40 – 59 ⃝ X-LARGE ⃝ E 60 + ⃝ XX-LARGE ⃝ $8.00 Run Only ⃝ $12.00 Late Registration After May 21, 2015 ⃝ XXX-LARGE ⃝ NO SHIRT-RUN ONLY INDEMNITY AGREEMENT In consideration for the acceptance of my application and their permitting me to participate in the 2015 Reardan Mule Days Fun Run; I, myself, my executors, my administrators and my assigns forever release all rights to ever make claims on my behalf against the Reardan Mule Days Association, its Board of Directors, Officers and/or Town of Reardan. I am aware that there is an element of risk involved with this event and I will accept responsibility for any injury for which I might incur. This is my written statement that I will assume and pay for my own medical and emergency expenses in the event of injury, accident, illness, or other incapacitation. I certify that I have prepared myself to be physically fit to participate in this event. I have read the above statement and understand it. In lieu of my written signature, I confirm its acceptance by typing my name and checking the accept terms box below. _________________________ SIGNATURE _____ DATE _________________________________ ______ PARENT OR GUARDIAN (IF UNDER 18) DATE MAIL ENTRIES TO: Reardan Mule Days - PO Box 241 - Reardan, WA 99029 - Phone: (509) 796-2102 E-mail: [email protected]
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