Dare 2 B Different Color Run

Registration Form

2017 Dare 2 B Different Color Run- School Sensory Playground Fundraiser.

*Color Run will be held RAIN or SHINE*

O= 5K $30.00 if received before June 10th $40.00 after June 11th

O= Kids Color Run $20.00 if received before June 10th $25.00 after June 11th

O=Race Day Sleep In: $______donation

Race Day Sleep in Option:(ALL donations are appreciated, No T-shirt/goodie bag received)

**NOTE ** Raceday registration CASH ONLY will be accepted. (Receipts will be available @ registration on raceday)

Name ________________________________________________ Address_______________________________________________ City ___________________________ State ____ Zip ________  Phone __________________

Emergency Contact: ___________________ Phone__________________ Age ________ Sex: M F (circle one)
T-Shirt Size: Adult S M L XL Child M L (circle one)

Participation WAIVER:

I know running/walking a road race is a potentially hazardous activity. I should not enter and run unless I am medically able and properly trained. I assume any and all risks associated with running/walking these events including but not limited to falls, contact with other participants, or with traffic. I therefore covenant not to sue, and waive and release any and all right and claims of every nature, whatsoever, that I may have or that may arise in connection with my participation in the event against the sponsors of this Color Run Fundraiser, and any organization or individuals associated with this event.

Signature (required) __________________________ Parents must sign if participant is under 18 years of age.

Email Address: ____________________________________

Mail Payment and Registration form to:

*ATTENTION* If a Non Sufficient Funds Check is received, CASH PAYMENT will be required at check-in to participate in Color Run. (no t-shirt will be ordered until cash payment is received- T-shirts will arrive at a later date after Color Run- you will be contacted to schedule a pick-up time once your T-shirt is available).

Karla Hemmann
C/O “Color Run Fundraiser”

327 Oak Street South

Norwood-Young America, MN 55368

Email: XDare2BDifferent@gmail.com