“We run so they don’t have to”.

Saturday July 28, 2012, Start & Finish Line are at the Gazebo on the corner of Kansas and Main.

Registration Starts 8:15 am. We ask that all participants be there no later than 8:40 am.

Start Times: 5K 9:00 am; 1 Mile Predict 9:45 am

General registration fee includes a red bracelet made by girls rescued from trafficking. Tanks and T-shirts are an additional fee.

Please put a check next to the race you want to run, and circle the shirt size.

______5K - $20.00 ______1 Mile Run/Walk - $15.00

______5K w/ Tank - $25 (XS, S, M, L, XL)______1 Mile Run/Walkw/ Tank - $20 (XS, S, M, L, XL)

______5K w/ T-shirt - $30 (XS, S, M, L, XL)______1 Mile Run/Walkw/ T-shirt- $25 (XS, S, M, L, XL)

______5K w/ Tank & T-shirt - $45 ______1 Mile Run/Walk w/Tank & T-shirt - $40

Participants under 10 years old: ______$5(includes bracelet)

If you wish to run in both races, please put a check next to both and add $5 to the price of the 5K option you choose.

There will be a hamburger feed after the race that's free for participants and only $5 per plate for any others who want to come eat!

First Name ______​______Last Name______​

Address______​______​______

City ______​______State ______Zip Code ______

Phone ______Email (for race updates) ______

Date of Birth ______​______Age ______Sex M F

____ My Payment is enclosed. (Make checks payable to Ulysses RTM 5K)

Mail registration form toKristin Baldwin • 609 E. Pawnee • Ulysses, Kansas 67880 • 620-353-9438

ONE ENTRY PER APPLICATION • THIS MAY BE REPRODUCED

Every Participant Must Sign This Wavier! Parent/Guardian for anyone under 18 must sign the wavier.

I know that running/walking a race is a potentially hazardous activity. I should not enter unless I am medically able. I agree to abide by any decision of a race official relative to my ability to safely complete the event. I assume all risks associated with this event including, but not limited to falls, contact with other participants, the effects of weather, and conditions of the trail, all such risks being known and appreciated by me. Having read this waiver and knowing these facts and in consideration of you accepting my entry, I, for myself and anyone entitled to act on my behalf; waive and release the Red Thread Movement event staff, and all volunteers associated with this event from all claims or liabilities of any kind arising out of my participation in this event even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver.

______

Participant’s Signature Date

______

Parent/Guardian SignatureDate