Form - Mule Kick 5k Mule Kick 5k

Transcription

Form - Mule Kick 5k Mule Kick 5k
The Wellness & Aquatics Complex invites you to the 15th
Annual Mule Kick 5K and 1-Mile Trot.
Walk or run through Riverside on a certified 5K course or the 1-mile trot. Bring the family and
enjoy the Mule Day festivities afterward!
Mule Kick 5K
Resolution Special
Only $20
(Ends January 31)
Race Information:
Mule Kick 5K - 8:00am
The Mule Kick 5K is a certified 3.1 mile race that begins at the Riverside Elementary
School near downtown Columbia, TN. The course will meander through the Riverside
neighborhood, return to Riverside Drive and then to a paved path in Riverwalk Park.
1-Mile Trot - 9:00am
The 1-Mile Trot is a shorter race for participants of all ages. This race started as an event
just for the kids but has grown to be a part of the Mule Kick that all ages enjoy. Awards
are reserved for participants under age 12 but is a great event for all ages and levels.
(Adults who participate in the 5K may accompany their children for free.)
**1-Mile Trot registration will open on February 1**
Registration Form
Name ____________________________________ Gender: M or F
Age________ (day of race) D.O.B. ________
Address ______________________________________________
City ________________________ State _______ Zip __________
Phone (___) ___-____ Email __________________________
__Mule Kick 5K -- $20
__ 1-Mile Trot (under 12 yr.) -- $10
__ 1-Mile Trot (13yr.+) -- $15
Payment Method: Check
Cash
Credit Card
*Make check payable to Wellness & Aquatics Complex or WAC
Shirt Size
Style
Men’s
Women’s
Youth
(Please circle one from each column)
Size
Staff Only:
Small
Initials __________
Medium
Date________
Large
Put in Lindsey’s box when completed
X-Large
Xx-Large
In consideration of your acceptance of my entry to this race, I , for myself, my facilitators, administrators and assigns, do hereby release and
discharge the Wellness and Aquatics Complex, and all sponsoring businesses and organizations, from all claims of damages, demands, actions,
and causes of actions whatsoever, in a manner arising or growing out of participation in this event. I also hereby consent to permit emergency
treatment in the event of injury or illness.
Signature: _____________________________Date ________
--------------------------------------------------------------------------------------------------------------------Mail in address: Mule Kick 5K – 1446 Oak Springs Drive – Columbia, TN 38401