West Valley Fun Run 5K and 1 Mile

March 3, 2007

11 a.m. for first race

5k and 1 Mile Run/Walk

Donations go to WV Track

Registration Form

 

 

Name (printed)_________________________________________________

                                      First                                         Last

Address_______________________________________________________

 

City____________________  State__________  Zip___________________

 

Email Address___________________________  Phone________________

 

Age on Race Day _______       Sex ____M ____F

 

Event:    ____ 5K   ____ 1 Mile

 

Pre-Registration

Pre-Registration includes a t-shirt, due on February 12, 2007

 

Event Fees:

 

5K with t-shirt                                             $10 _________

 

1 Mile with t-shirt                                           $8 _________ 

 

Shirt Size: (adult sizes)  ___S ___M ___L ___XL

 

Late Registration

Late Registration will be taken after February 12 up to the day of the race, but there will be no shirts given out.

 

Event Fees:

 

5K without shirt                                           $10  _________

 

1 Mile without shirt                                         $8  _________

 

Make checks payable to: West Valley School District

 

Send Money/Checks to:  Stacy Sundborg

                                      422 S 67th Ave

                                      Yakima, WA. 98908                                 

 

The event will be held between the West Valley Middle and Junior High Schools.  Located at 7505 Zier Road.

 

Feel free to contact Stacy Sundborg with any questions you may have. (509) 966-1635

 

Please read and sign the Release Waiver in order to participate in this event.  If you are under 18 years of age, a parent/guardian signature is required.

 

Race Release Waiver:

 

I know that running any race is a potentially hazardous activity.  I should not enter and run unless I am medically able and properly trained.  I agree to abide by any decision of a race official relative to my ability to safely complete the run.  I assume all risks associated with running in this event including, but not limited to:  falls, contact with other participants, the effects of weather, including high heat and/or humidity, cold and slippery wet conditions, and any other potential risks along the course will be 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 Stacy Sundborg, West Valley School District, all the volunteers involved on the race day, and every sponsor involved. I understand that bicycles, skateboards, baby joggers, wagons, roller skates or inline skates, and animals are not allowed in the race and will abide by this guideline.

 

 

___________________________                       _______________

Participants Signature                                             Date

 

 

___________________________                       _______________

Parent of Guardian if under 18                                Date