REGISTRATION -- Team Lone Tree Community Fun Run (5k

REGISTRATION -- Team Lone Tree Community Fun Run (5k)
Saturday -- March 21, 2015
One participant per registration form, please.
First and Last Name of runner/walker: _______________________________________________________________
Mailing Address: _______________________________________________________________________________
City/Zip: _____________________________________________________________________________________
Phone: _______________________________________Email:___________________________________________
Age on Race Day: ______________
Sex:
Male
Female
Please indicate your school classroom and your squadron or unit, if applicable (active duty, civilian, guard or other affiliation) to help
us determine the awards. Student registrants should indicate squadron of parent for credit towards the trophy tally. Notification to
the squadron commander will be made after registration closes and prior to the event to inform of honor.
Squadron or unit: ___________________________
Classroom Teacher: _____________________________
Mail your check and forms or drop them by the school office (7:30 a.m. – 3:30 p.m.)
Lone Tree School - 123 Beale Hwy. - Beale AFB, CA 95903
Child 5 – 18 years of age
 $15.00 with T-Shirt – please select shirt size
 Child under 5 years of age is free of charge, but please do register.
Adult
 $25.00 with T-Shirt – please select shirt size
 Youth Small
 Youth Medium
 Youth Large

$10.00 without T-Shirt
 $15.00 without T-Shirt
 Adult Small
 Adult Medium
 Adult Large
 Adult X Large
 Adult XX Large
Non-military ID holders (must submit by March 3) - please complete the following information and plan to enter through a gate no
later than 8:30 a.m. to ensure time to complete pass process. This is required for any adult in the vehicle when the person does not have a
military access pass or military ID. If you are a school parent with a school-day access badge, you will need to complete this information for
Saturday access to school:
CDL # __________________________________
Date of Birth: _____________________________
Full name as it appears on the CDL:
_________________________________________________________________________
No Refunds – Event will be held rain or shine.
My signature indicates I have read and agree to the following waiver, release, and permission.
I know that participating in this event may be potentially hazardous. I should not enter and participate unless I am medically able and properly
prepared. I agree to abide by any decision of the event officials relative to my ability to safely complete the 5k. I assume all risks associated with
participating including, but not limited to, falls, contact with other participants, the effects of weather, including high heat/humidity and/or rain,
traffic, conditions of the course, all such risk being known and appreciated by me. Having read this waiver and knowing these facts and in
consideration of your accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release Lone Tree School, Wheatland
Charter Academy, and Wheatland School District, school organizers, and all volunteers associated with this event, sponsor, their representatives,
event organizers, and their representatives and successors from all claims and liabilities of any kind arising out my participation in the event.
I grant permission to use any photographs, video, or any other record of this event for any legitimate purpose, including but not limited to
newspapers, school websites, school productions to share with families and community, and school promotions for future events.
Registrant Signature: _________________________________________ Date: __________________
Signature of Parent/Guardian (if registrant is under 18 years of age): _____________________________