Name: ______________________________________________________
Address: _____________________________________________________
City: ___________________State:_____________Zip:_________________
Phone #:__________________Birth Date: ___________Sex:_________
RACERS Community Race Series promo code:________
XYZ Trail Series member:_______
T-shirt size: (circle one) S M L XL XXL
Race: (circle one) 5K run, 5K walk, Kids 1 Mile Fun Run, 5K Bird Walk
Check your age category as of race day - April 6, 2013
14 & under____15-18_____19-24____25-29____30-34____35-39____40-44____ 45-49____50-54____55-59____60-64____65-69____70 & Over____
Please accept my entry in the Sarett Spring Stampede 5K run, 5K walk, or 1 mile kids run. I state that I believe I am physically fit for the event I enter. I waive any rights I may have against Sarett Nature Center, its employees, volunteers, consultants, or sponsors for damage or injuries occasioned by my participation in Sarett Nature Center's Spring Stampede 5K run and 5K walk.
Entrant's Signature_____________________________Date___________
Parent Signature (If under 18 years old) ___________________________