Registration Form - Marsh View Veterinary Clinic
Transcription
Registration Form - Marsh View Veterinary Clinic
Randolph SUMMER SIZZLER JUNE 18, 2016 All Events Held on Stark St. Proceeds Benefit the Randolph Teacher’s Care Fund Randolph Teacher’s Care Fund assists students in the Randolph School District who do not have the financial means to purchase school supplies, clothing, or other necessities. 5K Fun Run/Walk Begins at 8:00am - Part of Randolph’s 15K Challenge Series 3 on 3 Basketball Tournament As early as 9:00am Inflatables Fun Express Train Station, Deluxe Obstacle Course, Funny Farm $5 for wristband pass Petting Zoo • DJ • Face Painting • Food Vendors • Vendor Booths Children’s Games • Dunk Tank - 3 throws for a $1 (bring a nonperishable food item for the dunk tank and receive 3 FREE Throws) Bean Bag Toss Tournament Adult tournament begins as early as 2:00pm Live Music Events are subject to change with out prior notice. Events Sponsored by Randolph Chamber of Commerce and the following businesses: A&B Fitness Concepts, Beaver Dam Community Hospital, CenturyLink, Hacco, Inc./Neogen, Mailing Expert LLC, Markesan State Bank, Marsh View Veterinary Clinic, National Exchange Bank & Trust, Randolph Booster Club, Randolph Piggly Wiggly, Roberts Brothers Painting, Sam’s Well Drilling, SIA Insurance Services, United Wisconsin Grain Producers, and Schaumburg Supper Club In case of inclement weather, events will be held at Randolph Elementary/Middle School Please check out the Chamber Website for all Event Updates and Registration Forms - randolphwi.net 3 on 3 Basketball Tournament Bean Bag Tournament Downtown Randolph Starts as early as: 9 a.m. $40.00 Entry Fee for All Divisions Boys & Girls Entering Grade in September 2016 3rd & 4th Grade Division 5th & 6th Grade Division 7th & 8th Grade Division High School Division All Proceeds Benefit Randolph Teacher’s Care Fund Information: 16 Team Tournament Begins as early as 2 p.m. $25.00 Entry Fee Proceeds Benefit Randolph Teacher’s Care Fund The Teacher’s Care Fund provides school supplies, clothing, and other assistance to those families in the school district who otherwise would not have the monies to do so. Entry forms to be returned by June 1, 2016 Each player must sign the release & fill out the entry form information SIGN UP EARLY: 1st Place: $75 2nd Place: $50 3rd Place: $25 Download Registration Form at: www.randolphwi.net Download Registration Form at: www.randolphwi.net Summer Sizzler 5K Run/Walk 8 a.m. Awards to Top 2 Runners and Walkers 5K Run/Walk Starts and End on Stark St, Randolph Cost: $30 Pre-registration ends June 10 $35 Race Day Registration (not guaranteed shirt) $20 for Youth Runners up to age 18 $25 Youth Race Day Registration All Youth Runners Receive a FREE Wristband for the Inflatables Registration: Special Award to Top Father/Child Combined Times Mail to: W12025 County Road AA, Randolph WI 53956 or Drop off at Marsh View Veterinary Clinic 620 Jones Drive, Randolph WI 53956 Checks payable to: Proceeds benefit the Randolph Chamber of Commerce Randolph Teacher’s Care Fund Register Online at racemine.com (Search Summer Sizzler). Any questions contact Rita at mailingexpert1@gmail.com Name First and Last:____________________________ Birthday(d/m/yr):_____ Male:__ Female:__ Address: ______________________________________ E-mail Address: ________________________ City/State/Zip: _____________________________ Shirt Size: S M L XL Phone: (____) ________________________ 2XL (Circle one, 2XL is $2.00 more. Late Registration NOT guaranteed a shirt) Release form: Upon acceptance of this entry form, I waive all claims for myself and my heirs against the Randolph Chamber of Commerce, all Run Sponsors and The Village of Randolph, for injury or illness from direct or indirect participation. I also grant permission to use any photographs or other promotional record of this event for any legitimate reason. I further understand that there are no refunds if, for any reason, I am not able to run/walk the race or the race is canceled due to unforeseen circumstances. Signature______________________________________________ Date __________________ Signature of Parent or guardian (if under 18)______________________ Date___________________