Vista Strawberry Festival Run VUSD* Student Registration Sunday

Vista Strawberry Festival Run
VUSD* Student Registration
Sunday May 29, 2016
Hosted by:
Vista Chamber of Commerce
www.Strawberry5000.com
760-726-1122
Please print: ONE APPLICATION PER ENTRY!
Checks Payable to: Vista Chamber of Commerce
Completed form & fee must be Turned in to Your School PTA
Applications without payment will NOT be processed!
VUSD* STUDENT APPLICANT INFORMATION
First Name: ____________________________________
Gender: Male _____ Female _____
Last Name: ______________________________________________________________________
Address: __________________________________City/Zip: _______________________________
Phone#: _________________________________________________________________________
Email: ___________________________________________________________________________
T-Shirt Size (circle size, no changes @ check-in): YouthSm YouthMed Sm Med Lrg XLrg XXLrg ($2 xtra)
Birthday (mm/dd/yy): _______________________________
Age (on race day): ________
School Name: ____________________________ Team Name (optional): ____________________
Each Participant receives: t-shirt, goodie bag, medal, and fresh fruit!
VUSD* STUDENT FEE INFORMATION
Registration
Sponsored by:
Due April 8, 2016
X XX
VUSD Price:
1/4-Mile (For Children 2-5 Years Old ONLY) $20.00 $10.00 $ ________
1-Mile (For Children 6-12 Years Old ONLY) $20.00 $10.00 $ ________ 5K (Open to ANY AGE; 3.1 Mile Course)
$35.00 $25.00 $ ________
www.VistaStrawberryFest.com Total: $ ________
*This application is for the exclusive use of Vista Unified School District students.
WAIVER**
In consideration of this entry acceptance, I, my heirs, executors and administrators hereby waive any and all rights and claims
for damages I may have against the City of Vista, Vista Chamber of Commerce, Vista Unified School District, and all sponsors, or any individual associated with the above for any and all injuries sustained by me in this event. I will additionally permit
the use of my name and pictures in broadcasts, telecasts, newspapers, brochures, etc. I also understand that the entry fee is
non-refundable and non-transferable. I further attest and verify that I am physically fit and have sufficiently trained for competition and my physical condition has been verified by a licensed medical doctor. THIS WAIVER IS MANDATORY FOR EACH
PARTICIPANT. By paying for this event, you acknowledge having read it and agreeing to it.
IF ATHLETE IS UNDER AGE 18: This is to certify that my son/daughter has my permission to compete in the Strawberry 5K
and/or Kids’ Races, is in good physical condition, and that race officials have my permission to authorize emergency treatment if
necessary.
X ___________________________________________________________________________ Date: ____________________
**application must be signed or participant can not run!
Office Use Only:
Entered by: _______________ Date: _____________ Cash
Check Check #: __________
Sunday May 29, 2016
$3.00 for EVERY Runner Back to YOUR School
STUDENTS: USE REVERSE SIDE FOR SPECIAL
DISCOUNTED PRICING
Special Student Pricing!
5k - $25
1-Mile - $10
1/4-Mile - $10
www.Strawberry5000.com