Run4Roseville 2016 Registration Form 1 Mile, 5K and Lil` Ones 100

Transcription

Run4Roseville 2016 Registration Form 1 Mile, 5K and Lil` Ones 100
Run/Walk Event benefiting the 18 Roseville Elementary & Middle Schools
ALL PROCEEDS Support Music Education
Run4Roseville 2016 Registration Form
1 Mile, 5K and Lil’ Ones 100 Meter Dash
LOCATION: Maidu Community Park Softball Fields
1550 Maidu Drive
Roseville, CA 95661
RACE:
1 Mile, 5K and Lil Ones Free 100 Meter Dash
DATE:
Sunday, April 24
TIME:
8 am 1 Mile Run for 12 years and under
8:45 5K Run/Walk
9:45 Lil Ones 100 Meter Dash
Registration Pricing before April 1 ($10 increase after March 31)
Sponsorship Opportunities
Adults $35
Family Foundation Sponsorship: $150 includes up to 5 immediate
family members. Your family name proudly displayed at the
Run4Roseville. Increases to $175 after March 31
Children $25
Kids 4 & under are FREE and can participate in Lil One’s
100 Meter Dash. T-Shirt available for additional cost of $10
Family Discount Package: $100 Includes up to 5 immediate family members
$125 after March 31
Sponsor a Child: $20 Help a child or children run in the race whose family cannot afford to participate. Fee covers hard costs such as t-shirt, timing bibs, etc.
All participants must read carefully before signing waiver and release from liability.
I, intending to be legally bound, for myself, my heirs, executors, administrators, waive and release any and all rights and claims I may have against the RCSD Foundation, City of Roseville, Roseville City School District,
its agents, promoters and sponsors, and all persons, officials and organizations affiliated with the event for any and all injuries suffered by me while traveling to and from and while competing in the Run4Roseville. I
further attest that I am physically fit and sufficiently trained for this event. I also give my permission for the free use of my name and/or photographs in any broadcast, telecast, news print or any other account of this
event. I acknowledge I have read and fully understand my own liability and do accept the restriction. I have read and fully agree to the above.
Name _______________________________________________ School Name ___________________________________________________
Street Address ___________________________________________ City ________________________ State _______ Zip _________________
Email__________________________________________________ Phone_______________________________________
1 mile
5K
Name 1 ___________________ School ______________________ Gender
M
F DOB ____________ Shirt Size ___ Perf Shirt (add $10) ___
Name 2 ___________________ School ______________________ Gender
M
F DOB ____________ Shirt Size ___ Perf Shirt (add $10) ___
Name 3 ___________________ School ______________________ Gender
M
F DOB ____________ Shirt Size ___ Perf Shirt (add $10) ___
Name 4 ___________________ School ______________________ Gender
M
F DOB ____________ Shirt Size ___ Perf Shirt (add $10) ___
T-shirt is not guaranteed on the day of the Event
Signature (Parent/Guardian if Under 18): _____________________________________________________ Date: ________________________
The easiest way to register is online by visiting
To register manually, please mail completed registration
form and check payable to RCSD Foundation to:
Questions? Email info@Run4Roseville.com
RCSD Foundation 1050 Main Street Roseville, CA 95678
Run4Roseville.com
To
register, donate,
donate, or
or find
find more
more information
information please
please visit
visit Run4Roseville.com
Run4Roseville.com
To sponsor,
sponsor, register,
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