Printed Form - Reardan Mule Days

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]