Participant Entry Form Children’s Advocacy Center of Grays Harbor 5K Run/Walk “Rainbow Romp” July 30, 2016, 10 a.m. Fleet Park, Montesano, WA NAME: ____________________________________ Last Name First Name AGE: ADDRESS: Street City State Zip PHONE: _________________________ EMAIL: __________________________ T-SHIRT ADULT SIZE: ______SM ______MED _____LG _____XL _____XXL T-SHIRT KID SIZE: ______SM ______MED _____LG PARTICIPANT FEES: $30 per 5K walker/runner. $_______________ $_______________ $_______________ TOTAL AMOUNT ENCLOSED: $_______________ Please make checks payable to the Children’s Advocacy Center of Grays Harbor and mail to or bring to: Children’s Advocacy Center of Grays Harbor 514 Broadway Avenue East, Montesano, WA 98563 For more information call (360) 249-0005 or 1-800-959-1467 WAIVER: I know that participation in a road race is potentially hazardous. I should not enter and run or walk a race unless I am able to and properly trained. I assume the risk of running or walking in traffic. I also assume any and all other risks associated with participation in this event, including but not limited to falls. Contact with other participants, the effects of weather, including high heat and/or humidity, and conditions of the road, all such risks being known and appreciated by me. Knowing these facts, and in consideration of your acceptance of my entry fee, I hereby, for myself, my heirs, executors, administrators, or anyone else who might claim on my behalf, convenient not to sue, and waive, release, and discharge any organization associated with the race, and the local government and police, race directors, volunteers, and any and all sponsors including their agents, employees, assigns or anyone acting for or on their behalf, from any kind or nature, whatsoever arising out of, or in the course of my participation in this event. This release and waiver extends to all claims of every kind or nature, whatsoever, foreseen or unforeseen, known or unknown, I further grant full permission of this race and any organization conducting the race and/or agents authorized by them, to use any photography, videotape, motion pictures, recordings, or any other record of this event for any purpose. I have read the forgoing and certify my agreement by signature. PARTICIPANT’S SIGNATURE: ___________________________________________________ PARENT/LEGAL GUARDIAN: ___________________________________________________ |
4th Annual Rainbow Romp July 30th at 10 a.m. meeting in Fleet Park.
A fun filled 5K run/walk in Montesano, Washington modeled after the national "color runs" You will run or walk through 5 color stations and will end the event with a rainbow all over your body! Registration fee is $30.00 per person and children are encouraged to participate at the $30.00 fee. Register early to be sure that you get a cotton t shirt in the right size and sunglasses. To register, call 360-249-0005 - Thanks again for supporting the Rainbow Romp! Click to go to Facebook. This year, the funds raised will go to support our Parent Child Visitation Program. This program is under funded and over utilized. Children in foster care need to see and bond with their biological parents and those visits are not inexpensive. We transport children from their foster homes- which are all over Western Washington- to their visits and ensure that the children are safe and that the social workers know how the families interact together. Please help us to continue to serve as the bridge between children in the foster system and their biological families. |
