Proudly Presents The
Inaugural
Brian Mickelsen
Memorial Half Marathon
10K & 2 Mile Fun Run/Walk
April 18, 2009
Registration Starts @ 6:30
a.m.
Half Marathon Starts @ 7:30 a.m.
10K & 2 Mile Starts @ 7:45 a.m.
Location:
Riverfront Park
Cottonwood, AZ 86326
Registration Form
Please fill-out, print and sign the form.
Make check
Payable to: City of Cottonwood's Parks & Recreation
Mail to: Arizona RunningEvents Co. (ARC)
1963 E. Kentucky Lane ~ Tempe, AZ 85284
Last Name:
First Name:
Address:
City:
State: Zip:
Email Address:
Age Race Day:
Phone:
Gender:
Me
F
Event
Through 04/08/2009
After 04/08/2009
Half Marathon
$50.00
$55.00
10K
$30.00
$35.00
2 Mile Fun Run/Walk
$20.00
$25.oo
Entry Fee (from table above):
Event:
Half Marathon
10K
2 Mile Fun Run/Walk
T-shirt Size:
XS
S
M
L
XL
2X
Please read the waiver and sign the form. Thank You.
RELEASE FORM (MANDATORY):All applications MUST be signed to enter this event. No entry accepted without fee. NO REFUNDS.
WAIVER:
In consideration of accepting this entry, I the undersigned, intending to be
legally bound hereby, for myself my heirs, executors, and administrators
waive and release any and all rights and claims for damages I may have
against the Arizona RunningEvents Co., City of Cottonwood AZ or
anyone associated with this event, their representatives, successors and
assigns for any and all injuries suffered by me in said event. I will
additionally permit the free use of my name and pictures in broadcasts,
telecasts, newspapers, etc.
