| Registration Form | ||
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Name:___________________________ |
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| Address:__________________________________ | ||
| City:__________ State:____ Zip:________ | ||
| Phone:(____)_______________ | ||
| Email: ____________________________________________________ | ||
| Male: ____ Female:_____ Age:______ (on 10/5/08) | ||
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Event: Open 8K Run/Walk:_____ 3K Run/Walk:______ Kid’s 3K Race:________ 8K Wheelchair: Para_____ Quad________ |
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Please mail
completed form to: I want to make a tax deductible donation $________ (Make checks payable to: UA/DRC.) Registration through mail postmarked no later than 9/26/08. Entry Fee: Individuals...$20(through 9/26) or $22 (9/27-10/4) or $50 in collected pledges for free registration. Pledges are tax deductible and can be either mailed to the above address or turned in at packet pickup. SAR members and Active Duty Military receive a $2 discount if postmarked by 9/26. All complimentary entries expire on 9/27, please pre-register. Race day registration $25. Children age 12 and under receive a $3 discount on registration. Team Fee: Teams of 8 or more... ____x $18 = _____Total. Team Name:_________________________________ Entry fee is nonrefundable and not tax deductible. Race numbers are not transferable. Race will happen rain or shine. Register on line: www.Active.com. Race/registration questions email runnroll@azroadrunners.org. Please read and sign the following race waiver: In submitting this entry, I am intending to be legally bound. On behalf of myself, my heirs, executors, and administrators I hereby waive, release and forever discharge any and all rights and claims which may hereafter occur to me against the Disability Resource Center, The University of Arizona, University of Arizona Foundation, Southern Arizona Roadrunners, Jim Click’s Run ’n’ Roll, sponsors, directors, and volunteers from any and all claims, injury or actions sustained or suffered in connection with my participation in this event. I hereby grant full permission to all of the above to use my name, likeness and photographs for any publicity and promotional purposes without obligation or liability to me. Participant (sign): ___________________ Parent if under 18 years: ______________________ |
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