The following form is required be filled out completely in order to participate in the 5K Run / Walk. The event will begin at 9:30am on October 25th 2014. All proceeds will be donated to the Pellston and Petoskey Cross Country High School Teams.

On the day of the race please bring the appropriate fee based on your age group. $10.00 for kids 12 and under. $20.00 for anyone over 12 years old. The fee will include T-Shirts and awards.

Thank you.

Name

First Name

Last Name

Address

We like to know where our guest are from. No way will we share your information to the public. For internal use only.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email Address

Sex

Male

Female

Age

Anyone can run or walk the race.

I am 12 and under and understand the admission fee is $10.00

I am 12 and over and understand the admission fee is $20.00

Please Read Carefully

In consideration of acceptance of this entry to the Maple River resort run, I waive all claims for myself and heirs against the event sponsors, their agents, officers, and employees; the race organizers and all other participant organizations or individuals of injury or illness which may result from my participation in or travel to and from this event, and attest and verify that I have full knowledge of the risks involved and am in condition and trained to participate in this event. This release shall be binding upon all my distributors, heirs, next of kin, and personal representatives.

Date

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