Kids` Run Registration Form
Transcription
Kids` Run Registration Form
20th Annual Ghoulish Gallop Saturday, October 18, 2014 McKee Farms Park 8:30 a.m. Start Go to active.com for online registration. (Closes Thursday, October 16th at 5 pm.) Early Entry Fee: $25 (until September 28, 2014) Payment & entry form must be received by September 28. Advance Entry Fee: $30 (after September 28) Payment & entry form must be received by October 16. Race Day Registration: $35 Registration begins at 7:00 a.m. on race day. Pre-race day packet pick up will take place at Fleet Feet (8440 Old Sauk Rd., Madison) Friday, October 17, 2014 from 4 - 7 p.m. Registration and packet pick up will take place at McKee Farms Park Shelter from 7:00 a.m. - 8:15 a.m. on Race Day. Group Registration: $23 per person Receive a $2.00 per person discount by registering as a group of five or more. Group registrations must be received in the same envelope and must be received by September 28. Maps of the race courses are on our website: ghoulishgallop.com Start Time 9:30 a.m. Includes T-shirt & Culvers Scoop Coupon (while supplies last) 100 yard dash (4 & under) and Lap around Park (10 & under) FREE 10K/5K Run & 5K Irv Stein Memorial Walk Participants will receive an official Ghoulish Gallop long-sleeve Tech T-Shirt while supplies last. Preregister by September 28th to guarantee a shirt. All entry fees are non-refundable. Mail this completed form with check payable to: RASCW Housing Foundation 4801 Forest Run Road, Suite 101 Madison, WI 53704-7337 & Activities (7:00 a.m. Registration) Registration Information Registration Form Kids' Run Registration form at: ghoulishgallop.com Free Kids' Runs • Bouncy House • Costume Contest Race Entered: 5K Run 10K Run 5K Irv Stein Memorial Walk First Name: Last Name: Awards Plaques will be presented to male & female 10K & 5K run first place winners. Certificates for second and third place. Certificates will be awarded to first place finishers in the following age groups: 10 & Under 11-15 16-20 21-29 30-39 40-49 50-59 60-69 70-79 Costume Contest 80 & Up Best costume prizes will be given at the awards ceremony. You must be a participant in the race to participate in the costume contest. Directions to McKee Farms Park From I-90, Exit onto Hwy 12/18 West (Beltline) Exit Fish Hatchery Road (left) to Hwy PD (right) to Chapel Valley Road (left) to Brendan Ave (left) Turn right just before the tennis courts to get to the shelter For more information: 608.240.2800 ghoulishgallop.com Male Female Birthdate: Email Address: Daytime Phone: ( ) Address: City: State:Zip: Long-Sleeve Tech T-shirt Size: X-Small Small X-Large XX-Large Med Large No T-shirt Needed I hereby release the REALTORS® Association of South Central Wisconsin, the REALTORS® Association of South Central Wisconsin Housing Foundation and their employees and agents and any other people officially connected with this competition from all liability for any injuries or damages which I might suffer. Specifically, I release said persons from any liability or responsibility for my physical condition, for the condition of course route and for the presence or actions of any other participants. I also understand I will be billed $30 each for any unreturned timing chips. I authorize photos and/ or video taken of me at the event to be used in promotional material without notice or compensation. Participants under age 18 must have parent or legal guardian sign this form. Signature: Date: Please tell us where you received this brochure: race# Platinum Sponsors The Foundation The REALTORS® Association of South Central Wisconsin Housing Foundation is a non-profit organization under the IRS code 501(c)(3). Created in 1989, the purpose of the Foundation is to increase and improve the supply of affordable housing in Columbia, Crawford, Dane, Dodge, Grant, Green, Iowa, Jefferson, Lafayette, Richland, Rock and Sauk counties by providing down payment assistance in the form of low interest loans to individuals and families. In the 24 years of our existence the Foundation has given out over two million dollars in loans: $1,304,000 for individual loans, helping more than 480 families to successfully purchase homes in South Central Wisconsin and $870,000 to organizations to help with their affordable housing projects. Gold Sponsors 20th Annual R ASCW Ghoulish Gallop & Irv Stein Memorial Walk presented by The State Bank of Cross Plains Silver Sponsors The REALTORS® Association of South Central Wisconsin Housing Foundation – building a foundation for affordable housing in South Central Wisconsin. Saturday, O ctober 18, 2014 M c K ee F arms P ark , F itchburg Irv Stein Irv Stein was a valued Member of the REALTORS® Association of South Central Wisconsin for 30 years joining in 1958. He was one of the creators and founding Directors of the REALTORS® Association of South Central Wisconsin Housing Foundation. He served on the Foundation Board of Directors from the beginning, in 1989, until his unexpected death in 1998, including one year as President in 1991. Extremely active in both the REALTOR® organization and his community, the Foundation was one of Irv’s many ways of giving back. Thank You to our Food & Drink Sponsors Bagels Forever Miller & Sons Supermarket Starbucks Stella's Bakery New Logo - Same Great Run! Thank you to Aplus Graphic Services. Bronze Sponsors AnchorBank Bunbury & Associates, REALTORS® Capitol Bank Coldwell Banker Success Fairway Independent Mortgage First American Title Ins Co Gorman & Company, Inc Johnson Bank Keller Real Estate LLC Knight-Barry Title Oak Bank The Kruse Company, REALTORS® Realty Executives Cooper Spransy WHEDA Wisconsin Bank and Trust 10K /5K Run & 5K Irv Stein Memorial Walk & American Family Kids' Run 8:30 a.m. Start Kids’ Run - 9:30 a.m. All proceeds from the Ghoulish Gallop Benefit: Media Sponsors 608.240.2800 ghoulishgallop.com