Mail-in registration - Development Centers, Inc

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Mail-in registration - Development Centers, Inc
CUT ALONG DOTTED LINE
Saturday, July 11, 2015
PLEASE SEND FORM TO
DEVELOPMENT CENTERS
17421 TELEGRAPH RD., DETROIT, MI 48219
ATTN: RIVER SPLASH DASH
CHECKS PAYABLE TO: DEVELOPMENT CENTERS
Saturday, July 11, 2015
Start Times:
Registration & Packet Pick Up:
5K Run - 9:10 AM, 1 Mile Fun Walk - 9:12 AM
Kid’s Fun Run - 10:15 AM
Online registration will be available until
Friday July 10th at 12 noon.
Register Online at: www.develctrs.org
Location:
Rivard Plaza – Detroit RiverWalk
1340 Atwater Street, Detroit, MI 48207
Course and Amenities:
The Start and Finish lines will be located in
the Rivard Plaza. The 5K Course will follow
the Detroit Riverwalk Trail and the Dequindre
Cut. There will be water, fruit and various food
items at the Finish line for all participants.
All entries are eligible for prize drawings.
Shirts:
All pre-registered entrants will receive a high
quality short sleeve shirt. Sorry, but we cannot
guarantee shirts on race day to late registrants.
MF
3rd
Register by mail before July
. If you mail
your form after that date and it is not
received by race day, YOU ARE RESPONSIBLE
FOR PAYING THE FEE AND YOUR MAILED-IN
CHECK WILL BE SENT BACK TO YOU UPON
RECEIPT – NO EXCEPTIONS.
FIRST NAME
Race Day Registration and Packet Pick Up
will be from 8:00 AM to 9:00 AM.
ZIP/POSTAL CODE
BIRTHDATE
MM D D Y Y
ADDRESS
CITY
STATE
COUNTRY
EVENT SELECTION
5K Run
PHONE
Entry Fees:
On or Before June 30:
After July 1 or Before July 10th:
Race Day:
Kid’s Fun Run:
SEX
LAST NAME
1 Mile Fun Walk
$20.00
$25.00
$30.00
-FREE-
EMAIL ADDRESS
T-SHIRT SELECTION
Send Entries To:
ADULT SHIRT SIZES
SMALL
MEDIUM
Awards:
KID SHIRT SIZES
YOUTH SMALL
CUT ALONG DOTTED LINE
Development Centers
Prizes in the form of medals will be given to the 17421 Telegraph Rd., Detroit, MI 48219
5K Run Overall Male & Female Winners,
Attn: River Splash Dash
Overall Masters Male & Female Winners, and
MAKE CHECKS PAYABLE TO:
top three Male & Female winners of each group. Development Centers
Kid’s Fun Run
LARGE
YOUTH MEDIUM
X-LARGE
XX-LARGE
XXX-LARGE
ADD $1.00 FOR EITHER SIZE
YOUTH LARGE
DISCLAIMER, WAIVER AND RELEASE OF LIABILITY: I acknowledge that participating in a running style event is a
potentially hazardous activity. I agree to abide by any official race rules relative to safely competing in any event.
For and in consideration of my participation in the River Splash Dash, scheduled for July 11, 2015, for myself,
anyone entitled to act on my behalf, my executors, administrators and assignees, I do hereby release and discharge
all event personnel, volunteers, Development Centers Inc, the Detroit Riverfront Conservancy, and the City of
Detroit, and any and all sponsors jointly and severally and hold and save them harmless from and against any
and all actions, claims, demands, liabilities, loss damage or expense of whatever kind incurred by reason of my
participation in the aforesaid event. I attest and verify that I have full knowledge of the risks involved in this event
and I am physically fit and sufficiently trained to participate. I have read and accept the terms of this waiver.
ATHLETE (OR PARENT, IF APPLICANT IS UNDER 18)
DATE

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