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ARIZONA YOUTH
ROADRUNNERS
Proudly Presents Their 1st Annual
BORN TO RUN
5K Run/Walk ~ 1 Mile Fun
Run/Walk
April 1, 2012
Kiwanis Park ~
Tempe, AZ
North Soccer Field ~ Located
near the parking lot located off of Baseline Rd
Registration Starts @ 6:30 a.m. ~ Races Start @ 7:45 a.m.
You MUST include a check made out to AYRR with your entry form sign it, and mail to:
All AZ Running Events
5290 W. Melinda
Lane ~ Glendale, AZ 85308
For More Information Please Call Rachel
480-812-5020,
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Please circle which event you are participating in:
5K Run/Walk 1 Mile |
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Please Print
Name: _________________________
______________________________
Last Name
First Name
Address: ________________________________________________________
City: ____________________________ State:
_____ Zip: _______________
Phone:
________________________________________________________
Email:
_________________________________________________________
Age on Race Day: __________ Gender
(circle one): M F
T-Shirt Adult Size: YS
YM YL S
M L XL (Please circle one)
ENTRY FEES 5K Run/Walk 1 Mile
| Early Entry
Thru March 21, 2012 |
$20.00 |
$10.00 |
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| Postmarked
After March 21, 2012 |
$25.00 |
$10.00 |
| Race Day April 1, 2012
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$30.00 |
$10.00 |
Children under 10 are FREE in the 1 Mile ~ No T-Shirt
Amount Paid: $______________
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Please read the waiver and sign the form. Thank You.
RELEASE FORM (MANDATORY): All applications MUST be signed to enter this event. No entry accepted without fee. NO REFUNDS.
In consideration of your acceptance of this entry, I hereby, for myself, my heirs, my executors and administrators, waive any and all rights and claims for damages I may have against the sponsors,
AYRR, USATF, City of Tempe, All Arizona Running Events, Coordinating groups, and any individuals associated with the event, their representatives, successors and assigns, and will hold them harmless for any and all injuries suffered in connection with said event. Also, none of the above are responsible for the loss of personal items nor any other form of aggravation in connection with said event. I have been warned that I must be in good health to participate in this event. In filling out this form, I acknowledge that I am an amateur in such events. I also give permission for free use of my name and picture in any broadcast, telecast print media account of this event. In filling out this form, I acknowledge I have read and fully understand my own liability and do accept the restrictions. Signature:____________________________________________________________Date:________________
Parents signature (if under 18 years of age) & DATE)__________________________________________ |