For more info, contact Kaleigh Martino at (480) 262-8586 or kem92@nau.edu.
Name:
Date of Birth:
Mailing address:
City: State: Zip:
Phone: E-mail:
Please choose one: 5K Walk 8K Run
For Teams Only: Teams consist of five adults in the 5K walk or 8K run.
Team Leaders must submit this registration form and pay the $75 team fee.
Team Members must submit this registration form but DO NOT need to pay the $75 fee.
Team Name
Team Leader
WAIVER & RELEASE
In consideration of being allowed to participate in any way in this event, I:
I AM IN GOOD CONDITION AND AM SAFELY ABLE TO COMPETE IN THIS EVENT. I WILL ADDITIONALLY PERMIT THE USE OF MY NAME AND PICTURES IN BROADCAST, TELECASTS, WEBCASTS, NEWSPAPERS, BROCHURES, ETC. IN ADDITION, I PERMIT THE RELEASE OF MY ADDRESS IN ORDER TO RECEIVE FREE INFORMATION FROM RUNNERS-WORLD MAGAZINE.
I ACKNOWLEDGE THAT I HAVE READ THE WAIVER AND RELEASE, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT VOLUNTARILY. I VERIFY THAT THE ABOVE INFORMATION IS TRUE AND CORRECT.