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Run For Their Lives!
5K Run/Walk
Date: Saturday, May 30th, 2015
Location: Doepke Park,
Rib Mountain, WI
*Benefiting the Humane Society of Marathon County
Time: Registration: 7:30 to 8:30 am
9:00 am Chip Timed 5K start
***Participants accompanied by dogs will start behind competitive runners
Cost: Teams of 4 or more $25.00 per person
Registration alternatives: Active.com or printable registration brochure at
www.hsmcrunfortheirlives.com
Timing: Professional timing provided by Performance Timing
Parking: available at South Mountain Elementary, 5400 Bittersweet Road, Wausau WI
Awards: will be distributed by age division
Run/Walk participants who register early will be provided a performance dry fit t-shirt as well as post
race refreshments.
*Please register before May 8th to guarantee
shirt availability.
Volunteers are welcome! If you would like to organize a volunteer force for this race/walk please
contact HSMC’s Volunteer Coordinator for more information!
Wisconsin State Statute requires all dogs 4 months and older to be rabies vaccinated, and 5 months and older to be
licensed. If you are running with your furry friend, please have his tags securely fastened to his collar or harness.
Team Registration Form (Make as many copies as you need)
Team Name__________________________ * Register by May 8th to ensure shirt availability
Release: Each registrant must sign in the space provided below; by doing so you are agreeing to the following:
I do hereby release and hold harmless the Humane Society of Marathon County 5K Run/Fun Walk, including all organizers, sponsors,
volunteers, and property owners from any and all liability resulting from my participation in this event for any reason. I understand
that I, or my dependent, is participating in said run at our own risk. I understand my registration fee is nonrefundable if the event is
cancelled due to inclement weather.
----------------------------------------------------------------------------------------------------------------------------------------------------Name:____________________________________________________
Shirt Size: (Circle One) S
M
L
XL
XXL
Address:_________________________________________
Phone:_______________
Age:____________ Gender: (Circle One)
Male / Female
Check box if a woman wanting Men’s size
City/State/Zip:_____________________________________
E-mail:_______________________________________
May we e-mail you about future events? Yes / No
Yes! I am competing with my dog!
Dog’s name & age___________________________
Release Waiver Signature:__________________________________
----------------------------------------------------------------------------------------------------------------------------- -----------------------Name:____________________________________________________
Shirt Size: (Circle One) S
M
L
XL
XXL
Address:_________________________________________
Phone:_______________
Age:____________ Gender: (Circle One)
Male / Female
Check box if a woman wanting Men’s size
City/State/Zip:_____________________________________
E-mail:_______________________________________
May we e-mail you about future events? Yes / No
Yes! I am competing with my dog!
Dog’s name & age___________________________
Release Waiver Signature:__________________________________
----------------------------------------------------------------------------------------------------------------------------- -----------------------Name:____________________________________________________
Shirt Size: (Circle One) S
M
L
XL
XXL
Address:_________________________________________
Phone:_______________
Age:____________ Gender: (Circle One)
Male / Female
Check box if a woman wanting Men’s size
City/State/Zip:_____________________________________
E-mail:_______________________________________
May we e-mail you about future events? Yes / No
Yes! I am competing with my dog!
Dog’s name & age___________________________
Release Waiver Signature:__________________________________
----------------------------------------------------------------------------------------------------------------------------- -----------------------Name:____________________________________________________
Shirt Size: (Circle One) S
M
L
XL
XXL
Address:_________________________________________
Phone:_______________
Age:____________ Gender: (Circle One)
Male / Female
Check box if a woman wanting Men’s size
City/State/Zip:_____________________________________
E-mail:_______________________________________
May we e-mail you about future events? Yes / No
Yes! I am competing with my dog!
Dog’s name & age___________________________
Release Waiver Signature:__________________________________
----------------------------------------------------------------------------------------------------------------------------- ------------------------