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2nd Annual 5K Family Fun Run/Walk

Saturday, April 16th 2016

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- Location:   Hustisford High School   845 S Lake St, Hustisford, WI 53034

- $20/registrant, $15 per registrant/3 or more; for the 5K

- For more information call the Church office: 920.625.3538

- All proceeds for the Hustisford District Booster Club (Concession Stand/Restroom Project)

- 8:00 a.m. Registration

- 9:00 a.m. Kid's Run (1/4 mile, Kindegarten - 5th grade) Warm-up 

- 9:30 a.m. 5K Line-up

- 9:45 a.m. 5K Start

- 11:00 a.m. Diaper Crawl (infants/toddlers)

- 11:30 a.m. Community Scavenger Hunt

Concessions provided by the Lady Falcons Soccer team.

(Concession proceeds go to the Husty H.S. girls soccer team.)

 

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For advance registration

Click for Registration Form

or copy document below, complete and mail with entry fee to:

Faith Bible Alliance Church, W2799 Lehman Road, Neosho, WI 53059

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2nd Annual 5K Family Fun Run/Walk

 

List all participants; indicate which events attendees are participating in. Registration fee is for 5K only. All other events are free.

Make checks payable to: Faith Bible Alliance Church      No Refunds will be issued.


Name                                                              Age             5K           Kid's Run           Diaper Crawl       Scavenger Hunt

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Address: _______________________________________________________________________________

City, State, Zip: ________________________________________________________________________

Phone: _________________________  E-Mail: _______________________________________________

 

Waiver (MUST BE SIGNED)

In consideration of the acceptance of this entry I waive all claims for myself and my heirs against the sponsors, cooperating and coordinating groups and any individuals associated with this event and will hold them harmless for any and all injuries which may result from my participation. I hereby give my permission to the media to use my name and photograph in the newspaper, broadcast, and telecast of this event without limitation or obligation. I certify that I am physically fit for this event and understand the risks involved by participating in this event.

 

Signature: __________________________________________________    Date: _______________________

Signature: __________________________________________________    Date: _______________________

Signature: __________________________________________________    Date: _______________________

Signature: __________________________________________________    Date: _______________________

Signature: __________________________________________________    Date: _______________________

 

Parent or Guardian signature, if particpant(s) under 18:  _______________________________________________________


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