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2007 INDIVIDUAL MAIL-IN REGISTRATION FORM
Printable form
NOTE:
ENTRIES ARE NEITHER EXCHANGEABLE OR REFUNDABLE
BIB
# __________________ (Note:
Reissued BIB # Fee is $5.00)
USATF #_______________________
For Office Use Only For USATF Competitors Only
Entry Fees:
10K = $25.00 5K = $25.00 2K = $16.00
(Check one only)
2K Fun Run 10K
Run/Walk
10K Wheelchair 5K
Run/Walk
$1.00 discount for 10k USATF members
thru April 20 (10k only). Must include USATF # above.
Name:
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Last
First
MI |
Age:
Birthdate:
Gender: Male
Female |
(Age on April 28, 2007) Month Day
Year
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Address:

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City:

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State: Zip:
Phone: 
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E-mail ____________________________ |
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Would you
like to make a donation to 2nd Harvest Heartland? Enter
Donation Amount Here: $ _______________
(Amount will be added to total - to find out more go to
www.2harvest.org) |
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WAIVER
I know that running a road race is a potentially hazardous
activity. I should not enter and run unless I am medically able and properly
trained. I agree to abide by any decision of a race official relative to my
ability to safely complete the run. I assume all risks associated with
participating in this event including, but not limited to; falls, contact with
other participants or spectators, the effects of the weather-including heat or
high humidity-traffic or the conditions of the road surface, all such risks
being known and appreciated by me. Having read this waiver and knowing these
facts and in consideration of your accepting my entry, I, for myself and anyone
entitled to act for my behalf, waive and release the Get in Gear, INC., the
management personnel, the Minneapolis and St. Paul Park Boards and all sponsors
of the event, their representatives and successors from all claims or
liabilities of any kind arising out of my participation in this event even
though that liability might arise out of negligence or carelessness on the part
of the persons named in this waiver.
I understand that this event is being timed using
ChampionChip technology and I will be assigned a timing chip. I agree to accept
responsibility for the chip and will return it after the event. My failure to
return the chip may result in a $30.00 assessment.
I understand my failure to abide by the prohibition of
headphone devices will result in rejection of medical and liability insurance
coverage should incidences arise on the course affecting me.
I hereby irrevocably consent to and authorize the use and
reproduction by Get in Gear, Inc., or anyone authorized by Get in Gear, Inc., of
any and all photographs and video taken of me for any purpose whatsoever, without further
compensation. All photographs and videos shall constitute Get in Gear, Inc. property.
I have read and agree to the above.
Signature:
______________________________________
Is this your first Get in Gear race?
(circle one) Yes No
(If you are under age 18,
parents must sign here for you)
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Please Note! No entries will
be accepted on race day for any reason!
Must be post-marked no later than
April 21: In order to ensure your entries are processed into the data
base and have a chip assigned we cannot accept entries later than this.
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10K & 5K Run/Walk |
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2K Fun Run |
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Fit-For-Fun |
Online
Thru April 26, 2007, 11:59 pm
Pacific Time
$1.00 discount for 10k USATF
members thru April 20 (10k only)
Online Registration closes April 26,
11:59 pm Pacific Time |
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$23.00
To April 21
(plus $2.50
Active.com
processing fee)
$29.00
April 22-26(plus $2.50
Active.com
processing fee) |
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Online
Thru April 26, 2007, 11:59 pm
Pacific Time |
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$15.00
(plus
$1.98 Active.com
processing fee) |
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Online
Thru April 26, 2007, 11:59 pm
Pacific Time) |
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$13.00
(plus
$1.84
Active.com
processing fee) |
Mail-in
Thru 4/21 - postmark
$1.00 discount for 10k USATF
members thru April 20 (10k only) |
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$25.00 |
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Mail-in
Thru 4/21 - postmark |
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$16.00 |
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Click here for
Fit-For-Fun info |
In-Store
4/21 thru 4/26, 8:00pm |
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$30.00 |
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In-Store
4/21 thru 4/26, 8:00pm |
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$20.00 |
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Last day
Friday, 4/27 - onsite at Minnehaha
Park |
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$35.00 |
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Last day
Friday, 4/27 - onsite at Minnehaha
Park |
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$25.00 |
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Make your check payable to: |
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Get in Gear, Inc.
P.O. Box 6727
Minneapolis, MN 55406-0727
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Phone (612)
722-9004 Fax (612) 722-5414
E-mail:
Get in Gear |
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