Registration Form - AZ Water Association

4th ANNUAL RUN FOR WORLD WATER
5K Fun Run, 1K Walk and Kid’s
Lollipop Run
SATURDAY, MARCH 14, 2015
Kiwanis Park, 5203 S. Ash, Tempe, AZ
Give meaning to your miles and help Water For People
reduce water poverty in the developing countries of Africa,
Asia, Central and South America.
Entry Fees:
$30 prior to March 1, 2015
$35 March 1 to Race Day
Early Packet Pick-up
Friday, March 13, 4-7pm
Tempe Marketplace
Registration Methods:
 Register and pay online at: http://5krun.arizonawaterforpeople.org
 Or mail completed form and check payable to AZ Water to:
Laura McCasland, City of Scottsdale
8787 E. Hualapai Dr.
P.O. Box 25089
Scottsdale, Arizona 85255
Check-in/Registration:
Race Start:
Awards Ceremony
Course:
Race Amenities:
5K Awards:
7:15-8:15 AM At Baseline and Ash Rd
8:30 AM
5K
8:35 AM
1K Walk around Kiwanis Lake
9:15 AM
Kid’s Lollipop Run (50 yd. Dash)
9:30 AM
Chip timed and USATF certified course with varied terrain that includes grass, dirt and sidewalks.
T-shirt for all 5K and 1K pre-registrants and while supplies last for the Race Day Registrants, snacks,
Kid’s Face Painting, Massage and a DJ!
Top Overall Male and Female Finisher
1st and 2nd Place Male and Female Finishers in the following age groups:
19 and under 20-29 30-39 40-49 50-59 60 and over
Questions? Email azwaterforpeople@gmail.com or call 480-312-8717
Registration Form
Please print and complete entire form. One entry form per person. T-shirts for paid runners only.
Name: _______________________________________________________ Sex: M

F
 Age on Race Day: __________
Address: ______________________________________________________ City__________________ State ______ Zip_______
Phone: __________________ Email_______________________________ Shirt Size (adult) S____M____L____XL____XXL____
Event : 5K Fun Run_____1K Walk ______Lollipop Run (free)_____
Participate in the Corporate Challenge! Company or team with the most registered participants will receive an award!
 Yes  No Company /Team name: _____________________________________________________
Waiver: I know that participating in this walk/run is potentially hazardous. I should not enter unless I am medically able and properly
trained. I also assume any and all risks associated with this event including but not limited to falls, contact with other participants, the
effects of the weather, including high heat and/or humidity and the condition of the roads and traffic, all such risks being known and
appreciated by me. Knowing these facts, and in consideration of your accepting my entry, I hereby, for myself, my heirs, executors,
administrators, or anyone else who might claim on my behalf, covenant not to sue and waive, release and discharge the AZ Water
Association, Water For People, the City of Tempe or any agents authorized by them for any purpose. This release and waiver
extends to all claims of every kind or nature, foreseen or unforeseen, known or unknown. I further grant full permission for organizers
to use photographs, video tapes, recordings or quotations or other record in legitimate accounts and promotions of this event.
Applications for minors are accepted only with a parent/guardian signature.
Signature:
______________________________________________
Parent/Guardian if Participant is under age 18
Date__________________