Office Use Only Eventbrite Payment Budget Grant Park, Chicago, IL Saturday, April 4, 2015, 9 a.m. www.BunnyRock5k.com PLEASE SELECT A CATEGORY: 5K Run/Walk $35.00* Egg Hunt $10.00* *5K increases to $40 on (2/9), $45 on (2/23), and $50 on (3/30) *Egg Hunt increases to $15 on (3/30) *Registration form must be postmarked by that date to receive the current rate. First Name: Middle: Last Name: Birthdate: Gender: Male Email: Female Age: Phone: Address: City: State: Shirt Size: X-Small Small Medium Zip Code: Large X-Large 2XL 3XL *5K receives dri-fit, unisex, short sleeve t-shirt. *Egg Hunt receives basket and eggs ENTRY FEES: 5K Run/Walk $35.00 ($40 on 2/29) Egg Hunt $10.00 ($15 on 3/30) Pay By: Cash Check # CC Credit Card Type: Visa MC Card Number: Exp. Date: AmEx - / Discover - 3 Digit Code: *NO COUPON CODES FOR MAIL IN REGISTRATIONS MAIL FORM & CHECKS PAYABLE TO: Adrenaline Sports Management c/o Bunny Rock Chicago 770 Industrial Dr. Ste. A Cary, IL 60013 WAIVER AND RELEASE: In consideration of acceptance of this entry, I hereby for myself, my heirs, executors and administrators waive any and all rights and claims for damages I may have against the organizers and sponsors of the Bunny Rock Chicago 5k and Egg Hunt, Adrenaline Sports Management, the Chicago Park District, the City of Chicago, USA Track & Field, all sponsors, individuals associated with the event, their representatives, successors, assigns, for any and all injuries suffered by me in connection with said event, including pre- and post-race activities. I have been warned that I must be in good health to participate in this event and I attest and verify that I am physically fit and have sufficiently trained for this event. Adrenaline Sports Management also reserves the right to use any photographs of the event for marketing and promotion. PARENT OR LEGAL GUARDIAN - FOR PARTICIPANTS UNDER 18 YEARS OF AGE CANCELLATION POLICY: Entry fees are non-refundable & entries are non-transferable DATE
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