Form - Ridge Runner Sports
Transcription
Form - Ridge Runner Sports
Branson Tri-Lakes 2nd Annual 5K Run/Walk Saturday, April 4th, 2015-Branson Landing The EASTER BUNNY will be leading the race & greeting the kids! Registration Form In an effort of addressing the needs of our community, proceeds to benefit our local charity campaigns. Whether providing Christmas gifts to local school children, feeding those less fortunate or donating our time & labor to various charitable organizations, Keller Williams is committed to you & our community! QUESTIONS… Please call (417) 336-4999 or email [email protected]. We hope to see you there! Race Day Schedule 6:30am-7:40am Packet Pick-Up/Late Registration 8:00 am 5K Run/Walk RAIN OR SHINE Location Branson Landing- Fountain Area Entry Fees 5K - $20 (includes T-shirt & gift bag if registered by March 27th) Day of Race $25 (T-shirt & gift bag provided while quantities last) Family Registration $60 (Family of 4, all must live in same household) Age 5 & under FREE Awards Awards will be given to top overall male & female plus 1st, 2nd & 3rd in each category. *Under 11 *12-14 *15-19 *20-29 *30-39 *40-49 *50-59 *60-69 *70-79 *80-89 *90+ Timing Services Provided by Ozark Racing Systems Registration by cash, check or credit card. Credit card entries must be done at ozarkraces.com. Please make checks payable to Keller Williams. Please mail or deliver to 714 State Hwy 248 Suite #10, Branson, MO 65616. Online registration at ozarkraces.com. _______________________ ________________________ Last Name First Name T-Shirt Sizes Adult Sizes: ________________________________________________ Address Youth Sizes: S M L XL S M L XL XXL Amount Enclosed:__________ CASH ___________________________ __________ ________ City State Zip Code ___________________________ __________________ Email Phone Number CHECK ADDITIONAL NAMES FOR FAMILY REGISTRATION 1.______________________________________ 2._______________________________________ Age:_____ Date of Birth:_________ Sex: ___Male ___ Female 3._______________________________________ In consideration of your accepting this entry form, I, the undersigned, intending to be legally bound for myself, my heirs, executors and administrators, waive and release any and all right and claims for damages I may have against Keller Williams, the officials and sponsors of the Keller Williams 5k Run/Walk, whether caused by my negligence or that of Keller Williams or the officials, sponsors or volunteering working such Run. I acknowledge that I am aware of the inherent risks of participation in an athletic event of this type. I assume all risk of injury, whether or not caused by negligence, and release any claim I may have for any injury that I may sustain. I irrevocable grant full permission to Keller Williams to use photographs, videotapes, motion pictures and/or recordings of me, or any other record of this event for any legitimate purpose. __________________________________________________________________ Signature (If under 18, parent or guardian must sign) ___________________ Date Keller Williams Tri-Lakes Realty Branson (417) 336-4999 114 State Highway 248 Suite #10 Branson, MO 65616 Kimberling City (417) 739-4367 12907 State Highway 13 Kimberling City, MO 65686