2010 Marion Arts Festival 5K Run/Walk

Official Entry Form (2/2/10)

First Name _______________________________________________________

Last Name _______________________________________________________

Address _________________________________________________________

City _____________________________ State _______ Zip ________________

Phone ___________________________________________________________

E-mail ___________________________________________________________

Race day age: ____________ Sex: M_______ F________

Race: 5K Run _________ 5K Walk ___________

Clydesdale: Male 185+ lbs. ________ Athena: Female 140+ lbs. __________

Team Name (Three person): _______________________________________

Team Division (circle one): Middle School High School Corporate Open

T-Shirt (cotton/technical unisex sizes – circle one) S M L XL XXL

T-Shirt (technical women’s sizes – circle one) S M L XL

ENTRY FEES ARE NOT REFUNDABLE	100% Cotton Shirt	Technical Shirt Upgrade
Until March 20^st	$20	$25.00
March 21^st to May 14^th	$25	$30.00
Race day May 15^th	$30	N/A
For cotton shirts, correct sizes only guaranteed for applications received by May 10^th. Technical shirts cannot be ordered after Apr 17^th
Mail and make check payable to: Marion Arts Festival 5K
1225 6^th Avenue, Suite 100, Marion, IA 52302

In consideration of your acceptance of this entry, I for myself, my heirs, my executors, and administrators and assignees, forever release and discharge any rights, demands, claims for damages, and callers of suit or action, known or unknown, that I may have against the City of Marion, Linn County, The Marion Chamber of Commerce, The Marion Arts Festival, The Cedar Rapids Area Chamber of Commerce and any and all participating event sponsors and the directors, officers, employees, and agents of such parties, for any and all injuries resulting from my participation in the Marion Arts Festival 5K Run/Fun Walk, that I assume those expenses in the event of an accident, illness, or other incapacity regardless of whether I have authorized such expenses, and that I am physically fit and sufficiently trained to participate in this event. I release the rights to any and all photographic materials and computer information the race committee may release from this event without obligation to me.

Date: __________________ Signature: ______________________________________

If under 18 years old, signature must be parent or guardian